scholarly journals Abnormal spirometry after the Fontan procedure is common and associated with impaired aerobic capacity

2014 ◽  
Vol 307 (1) ◽  
pp. H110-H117 ◽  
Author(s):  
Alexander R. Opotowsky ◽  
Michael J. Landzberg ◽  
Michael G. Earing ◽  
Fred M. Wu ◽  
John K. Triedman ◽  
...  
Keyword(s):  
Exercise Capacity ◽  
Aerobic Capacity ◽  
Minute Ventilation ◽  
Fontan Procedure ◽  
Young Patients ◽  
Cross Sectional Study ◽  
Lung Mechanics ◽  
Cross Sectional ◽  
Exercise Limitation ◽  
Physiological Relevance

Impaired exercise capacity is common after the Fontan procedure and is attributed to cardiovascular limits. The Fontan circulation, however, is also distinctively vulnerable to unfavorable lung mechanics. This study aimed to define the prevalence and physiological relevance of pulmonary dysfunction in patients with Fontan physiology. We analyzed data from the Pediatric Heart Network Fontan Cross-Sectional Study to assess the prevalence and pattern of abnormal spirometry in Fontan patients (6–18 yr old) and investigated the relationship between low forced vital capacity (FVC) and maximum exercise variables, including peak O2consumption (V̇o2peak), among those who demonstrated adequate effort ( n = 260). Average ages at the time of exercise testing and Fontan completion were 13.2 ± 3.0 and 3.5 ± 2.2 yr old, respectively. Aerobic capacity was reduced (V̇o2peak: 67.3 ± 15.6% predicted). FVC averaged 79.0 ± 14.8% predicted, with 45.8% having a FVC less then the lower limit of normal. Only 7.8% demonstrated obstructive spirometry. Patients with low FVC had lower V̇o2peak(64.4 ± 15.9% vs. 69.7 ± 14.9% predicted, P < 0.01); low FVC independently predicted lower V̇o2peakafter adjusting for relevant covariates. Among those with V̇o2peak< 80% predicted ( n = 204/260), 22.5% demonstrated a pulmonary mechanical contribution to exercise limitation (breathing reserve < 20%). Those with both low FVC and ventilatory inefficiency (minute ventilation/CO2production > 40) had markedly reduced V̇o2peak(61.5 ± 15.3% vs. 72.0 ± 14.9% predicted, P < 0.01) and a higher prevalence of pulmonary mechanical limit compared with patients with normal FVC and efficient ventilation (36.1% vs. 4.8%). In conclusion, abnormal FVC is common in young patients after the Fontan procedure and is independently associated with reduced exercise capacity. A large subset has a pathologically low breathing reserve, consistent with a pulmonary mechanical contribution to exercise limitation.

Multiple Sclerosis: Treadmill Versus Cycle Ergometry Maximal Exercise Test Responses

2020 ◽  
Vol 9 (3) ◽  
pp. 113-117
Author(s):  
Garett Griffith ◽  
Badeia Saed ◽  
Tracy Baynard
Keyword(s):  
Multiple Sclerosis ◽  
Aerobic Capacity ◽  
Work Capacity ◽  
Cross Sectional Study ◽  
Cycle Ergometer ◽  
Cycle Ergometry ◽  
Cross Sectional ◽  
Complete Test ◽  
Peak Aerobic Capacity ◽  
Predicted Values

ABSTRACT Background: Multiple sclerosis (MS) is an autoimmune disease that impacts the central nervous system. MS generally results in decreased mobility and work capacity. Our objective was to determine exercise testing responses on both a treadmill and cycle ergometer among individuals with MS who were able to ambulate freely. Methods: Twenty-six individuals with MS participated in a cross-sectional study (44 ± 11 years; body mass index 26.8 ± 6.2 kg·m−2; expanded disability scale score 3.1 ± 0.9), with 24 individuals with complete test data for both treadmill and cycle ergometry tests. Peak aerobic capacity (VO2peak) for both treadmill and cycle ergometry tests were measured with indirect calorimetry. Results: Participants safely completed both treadmill and cycle ergometry tests, and treadmill testing yielded higher values (26.7 ± 6.4 mL·kg−1·min−1) compared with cycle ergometry (23.7 ± 5.7 mL·kg−1·min−1), with values ~12% greater for treadmill. When comparing tests to their respected predicted values within modality, treadmill tests were 8% lower and cycle ergometry tests were 10% lower than predicted. Conclusions: While peak aerobic capacity was very low for this population, treadmill tests were still higher than cycle ergometry data, with this difference between modes being similar to that observed in healthy adult populations. Additional research is required to determine if these findings are impacted by participation in physical activity or regular exercise.

Desigualdade social em doentes renais crônicos/ Social inequality in chronic renal patients

1970 ◽  
Vol 1 (1) ◽  
pp. 44-49
Author(s):  
Beatriz Bertolaccini Martínez ◽  
Fernanda Marcelino Da Silva ◽  
Vinícius Tavares Veiga ◽  
Rodrigo Pereira Custódio ◽  
José Vítor Da Silva
Keyword(s):  
Social Inequality ◽  
Access To Health Care ◽  
Young Patients ◽  
Cross Sectional Study ◽  
Access To Health Services ◽  
Access To Treatment ◽  
Cross Sectional ◽  
Economic Class ◽  
Access To Health ◽  
Clinical Background

Introdução: A pobreza influencia na evolução dos pacientes com doenças crônicas, porque contribui para o seu agravamento e dificulta o acesso à assistência médica. O objetivo deste trabalho foi avaliar os aspectos relacionados à desigualdade social de pacientes em hemodiálise. Métodos: Estudo transversal com 123 pacientes em hemodiálise no Hospital Samuel Libânio – Pouso Alegre, MG, divididos, de acordo com a classe econômica, em 3 grupos: AB (n=23), C (n=60) e DE (n=40),. Foram coletados dados sociodemográficos e econômicos, antecedentes clínicos e informações sobre o acesso a serviços de saúde. Para a análise dos resultados, foi utilizada estatística analítica e descritiva. Adotou-se p £ 0,05. Resultados: O grupo AB apresentou um menor número de pacientes jovens (4,3% em AB vs 40% em C e 25% em DE, p < 0,05), um maior número de indivíduos com mais anos de escolaridade (65,3% em AB vs 18,3% em C e 2,5% em DE; p < 0,05), predomínio de pacientes com menos de um ano em tratamento de hemodiálise (65,2% em AB vs 10% em C e 5% em DE, p < 0,05), menor número de usuários do SUS (40% em C e 25% em DE vs 4,3% em AB; p < 0,05) e maior acesso ao tratamento com nefrologista (73,9% em AB vs 46,7% em C e 52,5 em DE; p < 0,05). Conclusão: Classes economicamente desfavorecidas agregam indivíduos mais jovens, com menor escolaridade, usuários do SUS, com maior tempo em hemodiálise e pior acesso ao tratamento com nefrologista.Introduction: The poverty influence on the evolution of patients with chronic diseases because it contributes to your aggravation and hinders access to health care. Our goal was to evaluate the aspects related to social inequality on hemodialysis patients. Methods: cross-sectional study with 123 patients on hemodialysis in Samuel Libânio Hospital – Pouso Alegre, MG, divided according to the economic class, into 3 groups: AB (n = 23), C (n = 60) and DE (n = 40). Were collected socio-demographic and economic data, clinical background and information about access to health services. For analysis of the results has been used statistical analytical and descriptive. We take p £ 0,05.  Results: The AB group has fewer young patients (4,3% in AB vs 40% in C and 25% in DE, p< 0,05), a greater number of individuals with more years of schooling (65,3% in AB vs 18,3% in C and 2,5% in DE; p< 0,05), predominance of patients with less than a year on haemodialysis treatment (65,2% in AB vs 10% in C and 5% in DE, p< 0,05), smaller number of users of SUS (40% in C and 25% in DE vs 4,3% in AB; p< 0,05), greater access to treatment with nephrologist (73,9% in AB vs 46,7% in C and 52,5% in DE; p< 0,05). Conclusion: Economically disadvantaged classes bring younger patients, with less schooling, users of SUS, patients with greater time on hemodialysis and worse access to treatment with nephrologist. 

scholarly journals Frequent neurocognitive deficits after recovery from mild COVID-19

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Marcel S Woo ◽  
Jakob Malsy ◽  
Jana Pöttgen ◽  
Susan Seddiq Zai ◽  
Friederike Ufer ◽  
...  
Keyword(s):  
Short Term Memory ◽  
Telephone Interview ◽  
Acute Infection ◽  
Young Patients ◽  
Cross Sectional Study ◽  
Cognitive Status ◽  
Neurocognitive Deficits ◽  
Cross Sectional ◽  
Neuropsychiatric Complications ◽  
Moderate Disease

Abstract Neuropsychiatric complications associated with coronavirus disease 2019 caused by the Coronavirus SARS-CoV-2 (COVID-19) are increasingly appreciated. While most studies have focussed on severely affected individuals during acute infection, it remains unclear whether mild COVID-19 results in neurocognitive deficits in young patients. Here, we established a screening approach to detect cognitive deficiencies in post-COVID-19 patients. In this cross-sectional study, we recruited 18 mostly young patients 20–105 days (median, 85 days) after recovery from mild to moderate disease who visited our outpatient clinic for post-COVID-19 care. Notably, 14 (78%) patients reported sustained mild cognitive deficits and performed worse in the Modified Telephone Interview for Cognitive Status screening test for mild cognitive impairment compared to 10 age-matched healthy controls. While short-term memory, attention and concentration were particularly affected by COVID-19, screening results did not correlate with hospitalization, treatment, viremia or acute inflammation. Additionally, Modified Telephone Interview for Cognitive Status scores did not correlate with depressed mood or fatigue. In two severely affected patients, we excluded structural or other inflammatory causes by magnetic resonance imaging, serum and cerebrospinal fluid analyses. Together, our results demonstrate that sustained sub-clinical cognitive impairments might be a common complication after recovery from COVID-19 in young adults, regardless of clinical course that were unmasked by our diagnostic approach.

scholarly journals Increased modifiable cardiovascular risk factors in patients with Takayasu arteritis: a multicenter cross-sectional study

2021 ◽  
Vol 61 (1) ◽  
Author(s):  
Alexandre Moura dos Santos ◽  
Rafael Giovani Misse ◽  
Isabela Bruna Pires Borges ◽  
Bruno Gualano ◽  
Alexandre Wagner Silva de Souza ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Muscle Strength ◽  
Aerobic Capacity ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Metabolic Equivalent ◽  
Handgrip Test

Abstract Background Modifiable cardiovascular risk factors (MCRFs), such as those related to aerobic capacity, muscle strength, physical activity, and body composition, have been poorly studied in Takayasu arteritis (TAK). Therefore, the aim of the study was to investigate MCRFs and their relationships with disease status and comorbidities among patients with TAK. Methods A multicenter cross-sectional study was conducted between 2019 and 2020, in which 20 adult women with TAK were compared with 16 healthy controls matched by gender, age, and body mass index. The following parameters were analyzed: aerobic capacity by cardiopulmonary test; muscle function by timed-stands test, timed up-and-go test, and handgrip test; muscle strength by one-repetition maximum test and handgrip test; body composition by densitometry; physical activity and metabolic equivalent by IPAQ, quality of life by HAQ and SF-36; disease activity by ITAS2010 and NIH score; and presence of comorbidities. Results Patients with TAK had a mean age of 41.5 (38.0–46.3) years, disease duration of 16.0 (9.5–20.0) years, and a mean BMI of 27.7±4.5 kg/m2. Three out of the 20 patients with TAK had active disease. Regarding comorbidities, 16 patients had systemic arterial hypertension, 11 had dyslipidemia, and two had type 2 diabetes mellitus, while the control group had no comorbidities. TAK had a significant reduction in aerobic capacity (absolute and relative VO2 peak), muscle strength in the lower limbs, increased visceral adipose tissue, waist-to-hip ratio, reduced walking capacity, decreased weekly metabolic equivalent, and quality of life (P< 0.05) as compared to controls. However, there were no correlations between these MCRFs parameters and disease activity. Conclusions TAK show impairment in MCRFs; therefore, strategies able to improve MCRF should be considered in this disease.

Metabolic syndrome in people with a long-standing spinal cord injury: associations with physical activity and capacity

2016 ◽  
Vol 41 (11) ◽  
pp. 1190-1196 ◽  
Author(s):  
Sonja de Groot ◽  
Jacinthe J. Adriaansen ◽  
Marga Tepper ◽  
Govert J. Snoek ◽  
Lucas H.V. van der Woude ◽  
...  
Keyword(s):  
Physical Activity ◽  
Metabolic Syndrome ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Aerobic Capacity ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
The Metabolic Syndrome ◽  
Cord Injury ◽  
Peak Aerobic Capacity

This study investigated (i) the prevalence of the metabolic syndrome (MetS) in people with a long-standing spinal cord injury (SCI); (ii) whether personal or lesion characteristics are determinants of the MetS; and (iii) the association with physical activity or peak aerobic capacity on the MetS. In a cross-sectional study, persons with SCI (N = 223; time since injury of ≥10 years) were tested. The individual components of the MetS were assessed together with the physical activity measured by the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD), while peak aerobic capacity was tested during a graded wheelchair exercise test on a treadmill. Thirty-nine percent of the participants had MetS. In a multivariate logistic regression analyses and after performing a backward regression analysis, only age and education were significant determinants of the MetS. A 10-year increase in age leads to a 1.5 times more chance to have the MetS. Furthermore, people with a low education will multiply the relative risk of MetS compared with people with high education by almost 2. With and without correcting for confounders, no significant relationship was found between PASIPD or peak aerobic capacity and the MetS. It can be concluded that the prevalence of the MetS is high (39%) in people with a long-standing SCI but is comparable to the general Dutch population. Older people and those with a lower education level are most at risk for the MetS. Physical activity and peak aerobic fitness were not related to the MetS in this group with a long-standing SCI.

scholarly journals Predictive Factors of Development of Graves’ Ophthalmopathy for Patients with Juvenile Graves’ Disease

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Dalia Jarusaitiene ◽  
Rasa Verkauskiene ◽  
Vytautas Jasinskas ◽  
Jurate Jankauskiene
Keyword(s):  
Predictive Factors ◽  
Young Patients ◽  
Cross Sectional Study ◽  
Graves Disease ◽  
Cross Sectional ◽  
Ocular Manifestations ◽  
Graves Ophthalmopathy ◽  
Graves Orbitopathy ◽  
Low Incidence ◽  
Major Factors

Background. Due to low incidence of Graves’ ophthalmopathy (GO) among children, the manifestation is poorly analyzed, posing a risk to late identification of insidious disease.Purposes. To identify predictive factors that may influence the development of GO in pediatric and young patients with Graves’ disease (GD).Methods. A cross-sectional study of patients newly diagnosed with pediatric or juvenile GD during 2002–2012 was conducted at the Hospital of Lithuanian University of Health Sciences. Ocular evaluation was based on European Group on Graves’ Orbitopathy survey. The ocular manifestations were analyzed in relation to demographic, environmental, and clinical factors.Results. In total, 130 patients with juvenile GD were included; 29.2% had GO. Median age at GD onset was 17 yrs (IQR 4–29). Main symptoms of GO were eyelids retraction (73.7%), proptosis (65.8%), injection of conjunctiva (42.1%), and eyeball motility disturbance (21.1%). Major significant and independent risk factors for GO development were high initial concentration of FT4 (OR = 5.963), TTHAb (OR = 6.358), stress (OR = 6.030), and smoking (OR = 7.098).Conclusion. The major factors that could influence GO development were smoking, stress, and increased levels of initial TRAb, FT4. Slight proptosis, retraction of eyelids, and conjunctive injection were found as predominant ophthalmological symptoms in juvenile GO.

Clinical Profile of Young Patients with Erectile Dysfunction: Preliminary Findings of a Real-life Cross-sectional Study

2020 ◽  
Vol 6 (1) ◽  
pp. 184-189 ◽  
Author(s):  
Edoardo Pozzi ◽  
Paolo Capogrosso ◽  
Francesco Chierigo ◽  
Filippo Pederzoli ◽  
Eugenio Ventimiglia ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Real Life ◽  
Young Patients ◽  
Cross Sectional Study ◽  
Clinical Profile ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Aerobic capacity, physical activity and pain in adult victims of moderate to severe burns after discharge

2017 ◽  
Vol 39 (1) ◽  
pp. 37 ◽  
Author(s):  
Edna Yukimi Itakussu ◽  
Paola Janeiro Valenciano ◽  
Dirce Shizuko Fujisawa ◽  
Elza Hiromi Tokushima Anami ◽  
Celita Salmaso Trelha
Keyword(s):  
Physical Activity ◽  
Aerobic Capacity ◽  
High Body Mass Index ◽  
Cross Sectional Study ◽  
Pain Scale ◽  
Complete Healing ◽  
Moderate Intensity ◽  
Chi Square ◽  
Cross Sectional ◽  
Severe Burns

Burns cause different impacts on the individual life. Many are the problems faced by survivors, such as hypermetabolism that may persist years after the event. The aim was to assess aerobic capacity, level of physical activity and pain in adult burn victims after hospital discharge. This is a descriptive, cross-sectional study. Participants (n = 60) were adult victims of moderate to severe burns, evaluated by six-minute walk test (6MWT), Pain Scale and International Physical Activity Questionnaire (IPAQ). We applied Student’s t-test for independent samples and Mann-Whitney test for comparisons between medium and large burned; Chi-square test to compare the level of physical activity. Large burned (73%) patients prevailed among the 60 participants; there was a statistically significant trend in the distance predicted between groups (p = 0.066), with no change in performance of the aerobic capacity. 60% reported physical activity practice at least three times a week: walking, cycling and soccer. As for the level of pain, 40% reported moderate to severe persistent pain, even after complete healing of wounds. Most participants showed aerobic capacity within the normal range, despite the high body mass index reported, they reported doing physical activities of moderate intensity. 

scholarly journals Caracterização das lesões por pressão em adultos portadores de germes multirresistentes

2020 ◽  
Vol 19 (3) ◽  
pp. 155-192
Author(s):  
Andreia Macedo ◽  
Ariane Graciotto ◽  
Deborah Bulegon Mello ◽  
Leandro Augusto Hansel ◽  
Carolina Severo Lopes Cortelini ◽  
...  
Keyword(s):  
Assessment Tool ◽  
Young Patients ◽  
Multidrug Resistant ◽  
Lesion Size ◽  
Cross Sectional Study ◽  
Assessment Instrument ◽  
Cross Sectional ◽  
Positive Correlation ◽  
Home Support ◽  
Braden Scale

Objetivo: Describir las características de las lesiones por presión en pacientes adultos con gérmenes multirresistentes.Método: Este es un estudio transversal realizado con pacientes hospitalizados en la unidad de pacientes hospitalizados por gérmenes resistentes a múltiples fármacos de un hospital público en el sur de Brasil. Se seleccionaron pacientes con lesión por presión del estadio II. Los datos se recopilaron en 2017 de una muestra de 110 lesiones en 36 pacientes utilizando la Herramienta de evaluación de heridas Bates-Jensen (BWAT). Los datos se analizaron mediante estadísticas descriptivas y analíticas. Resultados: La edad promedio de los individuos fue de 45.4 (± 21.3) años y el 89.1% había sido hospitalizado con una lesión por presión, que ocurrió en el hogar o en otras instituciones de salud. El valor medio de BWAT fue de 35.5 ± 8.9 puntos y hubo una correlación positiva débil (r = 0.228 p = 0.017) con el tamaño de la lesión, correlación positiva moderada con el estadio de la lesión (r = 540 p <0.001). y con el resultado de la escala de Braden (r = 0.44 p = 0.651).Conclusión: Los resultados muestran la enfermedad de pacientes jóvenes. Los pacientes con gérmenes multirresistentes presentaron lesiones por presión con una mayor participación de las estructuras, lo que sugiere la necesidad de apoyo en el hogar. Objective: To describe the characteristics of the pressure lesions in adult patients with multiresistant germs.Method: This is a cross-sectional study conducted with patients admitted to the inpatient unit for multidrug resistant germs in a public hospital in Brazil. Patients with pressure lesions from stage II were selected. Data collection took place in 2017, in a sample of 110 injuries, in patients, through the Pressure Ulcer State Assessment Instrument (Bates-Jensen Wound Assessment Tool - BWAT). Results: The average age of the individuals was 45.4 (± 21.3) years old and 89.1% had already suffered pressure lesions, such as those that occurred at home or in other health institutions. The mean BWAT value was 35.5 ± 8.9 points and there was a weak positive correlation (r = 0.228 p = 0.017) with lesion size, moderate positive correlation with lesion stage (r = 540 p <0.001), and with the result of the Braden scale (r = 0.44 p = 0.651).Conclusion: The results indicated the illness of young patients. Patients with multiresistant germs suffered pressure lesions with greater involvement of structures, which suggests the need for home support.

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