We sought to describe responses to the 6-min walk test (6MWT) in healthy Canadian adults in order to facilitate interpretation of its results in patient populations. Seventy-seven healthy Canadians aged 45 to 85 years (65 ± 11 years, 40 females) completed this study. During a single visit, three 6MWTs were undertaken. The main outcome measure was 6-min walk distance (6MWD). Age, gender, height, and weight were recorded. In 61 (79%) participants, cardiorespiratory variables were collected during the third 6MWT using a calibrated portable gas analysis system. The 6MWD increased between the first and second test (615 ± 96 to 639 ± 98 m; p
OBJECTIVES: To validate the use of an activity diary and predicted BMR for assessment of daily total energy expenditure (TEE) and physical activity level (PAL = TEE/BMR) in adolescents. DESIGN: TEE and PAL estimated from activity diary records kept for seven days and BMR predicted from age, gender and body weight were compared with the results of doubly labelled water (DLW) measurements and indirect calorimetry performed during the same time period. SETTING: The Unit of paediatric Physiology of the Department of Clinical Physiology, University Hospital, Uppsala, Sweden. SUBJECTS: Fifty randomly selected 15 y old adolescents (25 boys and 25 girls). RESULTS: The mean difference between TEE estimated in all adolescents by the activity diary and by DLW methods was 1.2%. The limits of agreement (mean difference 2 s.d.) were -3.47 and 3.77 MD/d, equivalent to a coefficient of variation of 15%. The mean difference between PAL assessed by activity diary records and by DLW measurements was 0.001, and the limits of agreement between the two methods were 0.54. CONCLUSIONS: The results imply that the activity diary method provides a close estimate of TEE and PAL in population groups.
Anaesthesiologists from Oslo University Hospital have transported patients with severe oxygenation failure with inhaled nitric oxide (usually 20?ppm) from other hospitals to a tertiary care centre since 2002 in an effort to reduce the number of patients that otherwise would require transport with ongoing extracorporeal membrane oxygenation. The aim of this study was to evaluate the patient safety during transport with inhaled nitric oxide.
All patient transports with ongoing nitric oxide treatment undertaken from 2003 to 2012 were identified in the transport database. The frequency of adverse events and their impact on patient safety were studied in addition to response to inhaled nitric oxide and adjusted intensive care treatment and time aspects of the transports. Information about in-hospital treatment and survival were extracted from the hospital patient records.
Adverse events were recorded in 12 of the 104 transports. Seven of the adverse events were due to malfunctioning technical equipment, three were related to medication other than the inhaled nitric oxide and two were related to ventilation. No adverse events resulted in permanent negative patient consequences or in discontinuation of the transport. Out of 104 patients, 79 responded to treatment with inhaled nitric oxide and other treatment changes by an increase in oxygen saturation of more than 5%. The 30-day mortality was 27% in the group transported with inhaled nitric oxide.
Transporting patients on inhaled nitric oxide is an alternative in selected patients who would otherwise require extracorporeal membrane oxygenation during transport.
This study's objective was to assess the effects of a 12-month physical exercise intervention on work ability (WAI) and cardiorespiratory fitness (CRF) in healthy working adults.
The study group had 371 participants, of which 338 (212 women and 126 men) were allocated in the exercise group and 33 (17 women and 16 men) in the control group. The exercise group underwent a 12-month exercise program followed by a 12-month follow-up. WAI and CRF were evaluated at baseline, and at 4, 8, 12, and 24 study months, in both exercise and control groups. The exercise group was divided into subgroups according to baseline WAI classifications (poor/moderate, good, excellent).
During the 12-month exercise intervention, the exercise group increased their leisure-time physical activity by 71% (p = 0.016) and improved the mean WAI by 3% and CRF by 7% (p
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17 beta-Hydroxysteroid dehydrogenases (17HSDs) catalyze the interconversions between active 17 beta-hydroxysteroids and less-active 17-ketosteroids thereby affecting the availability of biologically active estrogens and androgens in a variety of tissues. The enzymes have different enzymatic properties and characteristic cell-specific expression patterns, suggesting differential physiological functions for the enzymes. Epidemiological and endocrine evidence indicate that estrogens play a key role in the etiology of breast cancer while androgens are involved in mechanisms controlling the growth of prostatic cells, both normal and malignant. Recently, we have developed, using LNCaP prostate cancer cell lines, a cell model to study the progression of prostate cancer. In the model LNCaP cells are transformed in culture condition to more aggressive cells, able to grow in suspension cultures. Our results suggest that substantial changes in androgen and estrogen metabolism occur in the cells during the process. These changes lead to increased production of active estrogens during transformation of the cells. Data from studies of breast cell lines and tissues suggest that the oxidative 17HSD type 2 may predominate in human non-malignant breast epithelial cells, while the reductive 17HSD type 1 activity prevails in malignant cells. Deprivation of an estrogen response by using specific 17HSD type 1 inhibitors is a tempting approach to treat estrogen-dependent breast cancer. Our recent studies demonstrate that in addition to sex hormone target tissues, estrogens may be important in the development of cancer in some other tissues previously not considered as estrogen target tissues such as colon. Our data show that the abundant expression of 17HSD type 2 present in normal colonic mucosa is significantly decreased during colon cancer development.
17 beta-Hydroxysteroid dehydrogenases (17HSDs) regulate the biological activity of sex steroid hormones in a variety of tissues by catalyzing the interconversions between highly active steroid hormones, e.g. estradiol and testosterone, and corresponding less active hormones, estrone and androstenedione. Epidemiological and endocrine evidence indicates that estrogens play a role in the etiology of breast cancer, while androgens are involved in mechanisms controlling the growth of normal and malignant prostatic cells. Using LNCaP prostate cancer cell lines, we have developed a cell model to study the progression of prostate cancer. In the model LNCaP cells are transformed in culture condition into more aggressive cells. Our data suggest that substantial changes in androgen and estrogen metabolism occur in the cells, leading to increased production of active estrogens during the process. In breast cancer, the reductive 17HSD type 1 activity is predominant in malignant cells, while the oxidative 17HSD type 2 mainly seems to be present in non-malignant breast epithelial cells. Deprivation of an estrogen response by using specific 17HSD type 1 inhibitors is a tempting approach in treating estrogen-dependent breast cancer. Our recent studies demonstrate that in addition to sex hormone target tissues, estrogens may be important in the development of cancer in some other tissues previously not considered to be estrogen target tissues, such as the gastrointestinal tract.
The primary purpose of this investigation was to examine the physiological profile of a National Hockey League (NHL) team over a period of 26 years. All measurements were made at a similar time of year (pre-season) in 703 male (mean age +/- SD = 24 +/- 4 y) hockey players. The data were analyzed across years, between positions (defensemen, forwards, and goaltenders), and between what were deemed successful and non-successful years using a combination of points acquired during the season and play-off success. Most anthropometric (height, mass, and BMI) and physiological parameters (absolute and relative VO2 peak, relative peak 5 s power output, abdominal endurance, and combined grip strength) showed a gradual increase over the 26 year period. Defensemen were taller and heavier, had higher absolute VO2 peak, and had greater combined grip strength than forwards and goaltenders. Forwards were younger and had higher values for relative VO2 peak. Goaltenders were shorter, had less body mass, a higher sum of skinfolds, lower VO2 peak, and better flexibility. The overall pre-season fitness profile was not related to team success. In conclusion, this study revealed that the fitness profile for a professional NHL ice-hockey team exhibited increases in player size and anaerobic and aerobic fitness parameters over a 26 year period that differed by position. However, this evolution of physiological profile did not necessarily translate into team success in this particular NHL franchise.
The purpose of the study was to investigate the associations of abdominal obesity and overall obesity with the risk of acute coronary events.
Body mass index indicating overall obesity and waist-to-hip ratio and waist circumference indicating abdominal obesity were measured for 1346 Finnish men aged 42-60 years who had neither cardiovascular disease nor cancer at baseline. There were 123 acute coronary events during an average follow-up of 10.6 years. In Cox regression analyses adjusted for confounding factors, waist-to-hip ratio (P=0.009), waist circumference (P=0.010) and body mass index (P=0.013) as continuous variables were associated directly with the risk of coronary events. These associations were in part explained by blood pressure, diabetes, fasting serum insulin, serum lipids, plasma fibrinogen, and serum uric acid. Waist-to-hip ratio of > or =0.91 was associated with a nearly threefold risk of coronary events. Waist-to-hip ratio provided additional information beyond body mass index in predicting coronary heart disease, whereas body mass index did not add to the predictive value of waist-to-hip ratio. Abdominal obesity combined with smoking and poor cardiorespiratory fitness increased the risk of coronary events 5.5 and 5.1 times, respectively.
Abdominal obesity is an independent risk factor for coronary heart disease in middle-aged men and even more important than overall obesity. Since the effect of abdominal obesity was strongest in smoking and unfit men, the strategy for lifestyle modification to prevent coronary heart disease should address these issues jointly.
Comment In: Eur Heart J. 2002 May;23(9):687-911977990
Formation of lactic acid by the extracts from the healthy rabbit muscles was studied as affected by the sera of embryos, newborn rabbits and pregnant female rabbits. The blood sera and beta-globulin isolated from them are established to activate anaerobic glycolysis and inhibit the Pasteur reaction. It is shown that protein typical of normal growth, belonging to beta-globulins and circulating in blood of the embryos, newborn rabbits from the first to the fifteenth day of development is "responsible" for this phenomena. Correlation is found between the precipitation test for detecting this protein and its biological effect on glycolysis and the Pasteur reaction.
We wished to determine the role of hypoxic chemosensitivity in high-altitude pulmonary edema (HAPE) by studying persons when ill and upon recovery. We studied seven males with HAPE and seventeen controls at 4,400 m on Mt. McKinley. We measured ventilatory responses to both O2 breathing and progressive poikilocapnic hypoxia. Hypoxic ventilatory response (HVR) was described by the slope relating minute ventilation to percent arterial O2 saturation (delta VE/delta SaO2%). HAPE subjects were quite hypoxemic (SaO2% 59 +/- 6 vs. 85 +/- 1, P less than 0.01) and showed a high-frequency, low-tidal-volume pattern of breathing. O2 decreased ventilation in controls (-20%, P less than 0.01) but not in HAPE subjects. The HAPE group had low HVR values (0.15 +/- 0.07 vs. 0.54 +/- 0.08, P less than 0.01), although six controls had values in the same range. The three HAPE subjects with the lowest HVR values were the most hypoxemic and had a paradoxical increase in ventilation when breathing O2. We conclude that a low HVR plays a permissive rather than causative role in the pathogenesis of HAPE and that the combination of extreme hypoxemia and low HVR may result in hypoxic depression of ventilation.