The significant relationship between platelet count and haemorrhagic complications on ECMO

Haemorrhagic complications, which occur in up to 35% of infants during extracorporeal membrane oxygenation (ECMO), often produce devastating sequelae. Although many complex factors interact to control haemostasis, platelet number and function has significant impact on the development of primary haemostasis. The optimum platelet count on ECMO, however, has not been defined. At our institution prior to August 1987, platelet counts were maintained at greater than 100 000/mm3. After August 1987, however, platelet counts of greater than 200 000/mm 3 were maintained. In a retrospective study, patients were randomly chosen from these two treatment periods: group 1 - March 1986 to July 1987; and group 2 - June 1988 to June 1989. The average platelet count, platelets administered, hours on ECMO, and bleeding complications were compared to each other and to the July 1992 ELSO Registry. There was a significant difference in average platelet counts between group 1 and group 2. However, the amount of platelets administered per kg per day was similar. There was a significant difference in overall bleeding complications between Group 2 (12%) and the ELSO Registry (35%) (p < 0.01). There was a trend towards decreased complications in all subgroups, although sample size precluded significance. We conclude that increasing platelet counts to greater than 200 000/mm3 decreases the overall bleeding complication rate. This advantage is achieved without a continuous need for increased platelet administration once the desired level is reached and without an increase in perfusion time, mechanical complications, or mortality.

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Use of Lenalidomide (Revlimid® +/− Corticosteroids in Relapsed/Refractory Multiple Myeloma Patients with Elevated Baseline Serum Creatinine Levels.

Blood ◽

10.1182/blood.v108.11.3548.3548 ◽

2006 ◽

Vol 108 (11) ◽

pp. 3548-3548 ◽

Cited By ~ 4

Author(s):

Donna E. Reece ◽

Esther Masih-Khan ◽

Christine Chen ◽

Lisa Wang ◽

Saima Dean ◽

...

Keyword(s):

Multiple Myeloma ◽

Platelet Count ◽

Serum Creatinine ◽

Median Number ◽

Bleeding Complications ◽

Baseline Serum ◽

Prior Therapy ◽

Group 2 ◽

Grade 3 ◽

Group 1

Abstract Lenalidomide (Revlimid®; Rev) is an important novel agent for the treatment of multiple myeloma (MM) patients (pts). Since MM pts are at risk for renal insufficiency, we evaluated whether an abnormal serum creatinine (cr) level affected the outcome of pts treated with Rev +/− corticosteroids (CS). Between 12/05 and 07/06, 69 MM pts who had progressed after at least 1 line of prior therapy were treated in our center with Rev +/− CS as part of Celgene’s Expanded Access Program in Canada. Eligibility criteria included a platelet count (pl ct) ≥ 30 x 109/L and neutrophil count ≥ 1.0 x 109/L; a cr level of ≤220 umol/L was required unless a waiver was obtained. Protocol therapy consisted of Rev + dexamethasone (dex) in 44, Rev + prednisone in 7, Rev + dex and prednisone at different time points in 5 and Rev alone in 13. The median age was 60 yrs (35–79); 36 (52%) were male; median β2-microglobulin was 214 nm/L (114–1420); Ig subtype was IgG in 42, IgA in 12, IgM in 1 and light chain only in 14. Prior therapy included ASCT in 59 pts (86%), thalidomide in 51 (74%), bortezomib in 21 (30%) and oral cyclophosphamide in 52 (75%); the median number of prior regimens was 2 (1–5). Twenty-three pts (33%) had an elevated baseline cr level (> 89 umol/L for females and 109 umol/L for males in our center). The median cr was 138 umol/L (110–412) in these pts (group 1), compared with 80 umol/L (51–109) in group 2 (control) (p=0.001). Five pts in group 1 had a cr level ≥ 177 umol/L (2 mg/dL). Both groups were similar except that group 1 had more males (p=0.04) and the baseline platelet count (pl ct) was lower (35% vs. 4% with pl ct less than 50 x 109/L; p=0.0007). RESULTS: The median number of cycles of Rev +/− CS given to date was 4 (1–8) in both groups, and the median follow-up is 4 mos (0.5–8). After 3 cycles of Rev, the median cr was 104 umol/L (61–372) in group 1 and 79 umol/L (53–180) in group 2. In group1, cr decreased in 39% and increased in 26%, compared with 39% and 32% in group 2, respectively (p=0.56). The incidence of grade 3–4 neutropenia was 43% vs. 46%, febrile neutropenia 13% vs. 9%, any infection 17% vs. 20% and G-CSF use 66% vs. 57% among pts in group 1 vs. 2 (p=NS for all comparisons). More in group 1 experienced grade 3–4 thrombocytopenia and required at least 1 pl transfusion (52% vs. 17%; p=0.003). In group 1, 6 (26%) pts required pl transfusion in only 1 cycle, 5 (22%) in 2 cycles and 1 (4%) in 3 cycles. However, the only 2 significant bleeding complications were seen in group 2. There were 2 deaths (8.7%) in group 1 and 4 (8.7%) in group 2. Table 1 summarizes the preliminary anti-myeloma results in these 2 groups. CONCLUSIONS: Rev +/− CS can be given safely to selected patients with an elevated baseline cr level; pts with an elevated cr had lower baseline pl cts, and required more pl transfusions; the response rate, PFS and OS to date are similar in patients with a normal vs. elevated cr level. Table 1 Serum cr N nCR/PR PFS 95% CI OS 95% CI PFS=progression free survival; OS=overall survival; the differences are not significant. Elevated 23 61% 30% 11–52% 72% 46–86% Normal 46 54% 50% 31–67% 76% 55–88%

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PLATELET COUNT INCREASES IN CHRONIC OTITIS MEDIA PATIENTS WITH BLOCKED EUSTACHIAN TUBE

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i5.244 ◽

2019 ◽

Vol 3 (5) ◽

Author(s):

Okan DIKKER ◽

Cem ALTINDAĞ ◽

Güven YILDIRIM ◽

Tolgar Lütfi KUMRAL

Keyword(s):

Platelet Count ◽

Otitis Media ◽

Eustachian Tube ◽

Chronic Otitis Media ◽

Residual Pressure ◽

Old Patients ◽

Significant Difference ◽

Group 3 ◽

Group 2 ◽

Group 1

Objectives: The aim of the present study was to examine the levels of complete blood count (CBC) parameters (Neutrophil, lymphocyte, platelets, MPV, NLR, and PLR) in patients with both perforated eardrums and dysfunctional eustachian tubes to determine which of these parameters might be reliable biomarkers of chronic otitis media prior to surgery, as inflammation is significant component of middle ear pathology. Materials and methods: In this study, we enrolled 95 patients with 18-65 years old. Patients with chronic otitis media (perforated tympanic membranes) more than three months in duration who have no draining ears, were enrolled in Okmeydani Training & Research Hospital. Patients were divided into three groups: Group 1 is “Open eustachian tube” group in which pressure changes (if evident) during swallowing were recorded on stepladder-type graphs; Group 2 is “Blocked” group, who could not neutralize the negative pressure even by repeated swallowing. Group 3 is “Partially blocked” group in whom some residual pressure persisted even after five swallows. The groups were compared in terms of laboratory tests. Results: There was a statistically significant difference between 3 groups in terms of platelet levels (p>0.05). We found that group 2 / blocked eustachian tube had significantly increased platelet counts values when compared to the group 1 and 3. There was no significant difference among group 1 and group 3. There was no statistically significant difference between the 3 groups in terms of neutrophil, lymphocyte count, MPV, NLR, PLR levels, bone and air hearing thresholds. Conclusion: We found that the platelet count increased in chronic otitis media patients with blocked eustachian tube. This may be a simple and inexpensive biomarker with acustic impedencemeter tests supporting eustachian dysfunction before tympanoplasties. Key Words: Hematological biomarkers; eustachian tube dysfunction; chronic otitis media

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Platelet Number and Function in Diamond-Blackfan Anemia

PEDIATRICS ◽

10.1542/peds.68.2.238 ◽

1981 ◽

Vol 68 (2) ◽

pp. 238-241

Author(s):

George R. Buchanan ◽

Blanche P. Alter ◽

Christine A. Holtkamp ◽

Elaine G. Walsh

Keyword(s):

Platelet Count ◽

Platelet Aggregation ◽

Platelet Function ◽

Signs And Symptoms ◽

Red Cell ◽

Normal Range ◽

Platelet Counts ◽

Diamond Blackfan Anemia ◽

Platelet Number ◽

And Function

Congenital red cell aplasia (Diamond-Blackfan anemia) is occasionally associated with hematologic defects other than a deficiency of red blood cell progenitors, but such alterations have not been well studied. The frequency and magnitude of abnormalities in platelet count and platelet function were therefore examined in 38 patients. Thrombocytosis was seen in 21 patients, and 12 had mild thrombocytopenia on at least one occasion. Elevated platelet counts were demonstrated repeatedly in nine children. The three patients with the lowest platelet counts also had leukopenia. Platelet aggregation was normal in all 16 patients in whom it was studied, and bleeding times were within the normal range in 14 of them. Bleeding signs and symptoms were not observed. It is concluded that thrombocytosis or thrombocytopenia often occurs but that platelet function is normal in patients with Diamond-Blackfan anemia.

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The Feasibility of High-Dose Dexamethasone (HD-DEX) in Idiopathic Thrombocytopenic Purpura (ITP) in Adults; a Multi-Center Study in Korea.

Blood ◽

10.1182/blood.v106.11.4009.4009 ◽

2005 ◽

Vol 106 (11) ◽

pp. 4009-4009

Author(s):

Yeo-Kyeoung Kim ◽

Je-Jung Lee ◽

Moo-Rim Park ◽

Sung-Hwa Bae ◽

Hyo Jung Kim ◽

...

Keyword(s):

Initial Response ◽

Hypoglycemic Agents ◽

Ulcer Bleeding ◽

High Dose ◽

Success Rates ◽

Platelet Counts ◽

High Dose Dexamethasone ◽

Significant Difference ◽

Group 2 ◽

Group 1

Abstract Short term use of HD-DEX has shown less adverse effects (AEs) than PDS maintenance but its success rates reported differently by several studies. The objective of this study was to determine HD-DEX effectiveness in adult ITP with newly diagnosed (group 1) and relapsed after other treatments(Tx) (group 2). 71 (median age; 45, 20~82) with ITP with a platelet counts (PC) 20,000/uL or less than 50,000/uL and clinically significant bleeding were enrolled. DEX a dose of 40 mg/day for 4 consecutive days was tried. A response was defined as an increase in the PC of at least 30,000/uL, PC of more than 50,000/uL by day 10 (D10) after DEX. A maintenance was defined as a PC of more than 50,000/uL 6 ms after Tx. The number of group 1 and 2 were 54, 17, retrospectively. In group 2, previous regimens included;oral PDS and/or IVIG (16)and splenectomy (4). Median PC before Tx were 8,500(1,000~45,000/uL) and 9,000(100~33,000/uL) in group 1 and 2, retrospectively (p=0.80). 27(50%) and 6(35.3%) in group 1, 2 showed good initial response to 1st course of DEX, retrospectively (p=0.40). After 1st course of DEX, 11(20.3%) in group 1 and 1(5.9%) in group 2 could maintain response for 3 ms (p=0.27). By 6 ms, 8 (14.8%) in group 1 and 1 (5.9%) in group 2 kept first response (p=0.68). Among 33 patients bearing initial response, 12 (44.4%)and 2 (33.3%) in group 1, 2 relapsed (p=1.0). Good correlation revealed between PC (D10) and response rate (RR) (p<0.05). Of 21 with PC (D10) above 100,000/uL, 6(28.6%) experienced relapse. On the other hand, nine of 11 patients (81.8%) in whom PC (D10) were less than 100,000/uL relapsed after all. There was no significant difference in relapse-free survival (RFS) after 1st DEX between 2 groups (p=0.9). 13 of 14 relapsed received 2nd DEX and then maintained PDS without interruption. After several weeks of maintenance, PDS tapered according to the PC. 9(75.0%) in group 1 and 2(100%) in group 2 showed response in 2nd DEX. Of these 11 patients, 2 in group 1 relapsed 10 ms after receiving 2nd DEX. After 1st DEX, 12 (16.9%), 5(7%) and 6 (8.5%) temporarily suffered from vague generalized sx., facial edema, and mild liver function abnormality, retrospectively. During the 2nd DEX and consecutive oral PDS, 4(30.7%), 3(23.1%) and 1(7.7%) experienced same AEs, retrospectively. Additionally, of these 13, overt DM requiring hypoglycemic agents appeared in 2(15.4%) and 1(7.7%) experienced duodenal ulcer bleeding. In conclusion, 1 course of HD-DEX revealed good initial response in group 1 but in group 2, the RR was lower than in historical results of oral PDS. However, it has an advantage for the patients to have a good compliance to the Tx because of few AEs and no need to maintain long-term daily medication. Furthermore, although the 2nd DEX and PDS maintenance showed good response, it revealed no benefit compared as a previously established oral PDS regimen because of frequently occurrence of AEs and poor compliance. Therefore, the proper DEX schedule remained to be determined according to the early achieved platelet counts (eg. D10) with 1st course DEX or to the presence of previous Tx.

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In-vivo evaluation of the effect of cyanoacrylate on prosthetic vascular graft infection – does cyanoacrylate increase the severity of infection?

VASA ◽

10.1024/0301-1526/a000867 ◽

2020 ◽

Vol 49 (4) ◽

pp. 281-284

Author(s):

Atıf Yolgosteren ◽

Gencehan Kumtepe ◽

Melda Payaslioglu ◽

Cuneyt Ozakin

Keyword(s):

Vascular Graft ◽

Graft Infection ◽

Vascular Graft Infection ◽

Group 4 ◽

Significant Difference ◽

Group 3 ◽

Group 2 ◽

Prosthetic Vascular Graft Infection ◽

Group 1

Summary. Background: Prosthetic vascular graft infection (PVGI) is a complication with high mortality. Cyanoacrylate (CA) is an adhesive which has been used in a number of surgical procedures. In this in-vivo study, we aimed to evaluate the relationship between PVGI and CA. Materials and methods: Thirty-two rats were equally divided into four groups. Pouch was formed on back of rats until deep fascia. In group 1, vascular graft with polyethyleneterephthalate (PET) was placed into pouch. In group 2, MRSA strain with a density of 1 ml 0.5 MacFarland was injected into pouch. In group 3, 1 cm 2 vascular graft with PET piece was placed into pouch and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. In group 4, 1 cm 2 vascular graft with PET piece impregnated with N-butyl cyanoacrylate-based adhesive was placed and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. All rats were scarified in 96th hour, culture samples were taken where intervention was performed and were evaluated microbiologically. Bacteria reproducing in each group were numerically evaluated based on colony-forming unit (CFU/ml) and compared by taking their average. Results: MRSA reproduction of 0 CFU/ml in group 1, of 1410 CFU/ml in group 2, of 180 200 CFU/ml in group 3 and of 625 300 CFU/ml in group 4 was present. A statistically significant difference was present between group 1 and group 4 (p < 0.01), between group 2 and group 4 (p < 0.01), between group 3 and group 4 (p < 0.05). In terms of reproduction, no statistically significant difference was found in group 1, group 2, group 3 in themselves. Conclusions: We observed that the rate of infection increased in the cyanoacyrylate group where cyanoacrylate was used. We think that surgeon should be more careful in using CA in vascular surgery.

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Tuberculosis of the meninges and central nervous system. Experience of clinical diagnostics in St. Petersburg for 50 years

MedAlliance ◽

10.36422/23076348-2020-8-1-14-24 ◽

2020 ◽

Vol 8 (1) ◽

pp. 14-24

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Medical Errors ◽

Clinical Diagnostics ◽

Lethal Outcome ◽

Significant Difference ◽

Group 2 ◽

Allergic Vasculitis ◽

Tuberculosis Meningitis ◽

Group 1

The clinic and diagnostics of tuberculosis meningitis (TM) in 926 patients treated in St. Petersburg hospitals in 1965–1994 (group 1) and in 1995–2018 (group 2) is presented. The TM clinic is demonstrated to be determined by the form of tuberculosis and its characteristic generalization nature in the presence of repeated waves of bacteremia and allergic vasculitis of greater or lesser severity. There is clinical peculiarity of TM in primary pulmonary tuberculosis and its early large-focal and late miliar generalization, as well as in hematogenous tuberculosis. In patients of the 1st and 2nd groups the TM clinic shows in some respects a noticeable similarity, in others — a significant difference. Despite the typical symptoms, early diagnosis of TM took place in less than 20% of patients. Clinical examples illustrating the unusual development of TM, contrasting with its usual course, are given. A number of objective and subjective factors contributing to the adverse evolution of TM and its lethal outcome are discussed. These include the peculiarity of modern tuberculosis, especially when associated with HIV infection, as well as medical errors associated with ignorance of the pathogenesis of tuberculosis and failure to comply with the minimum examination for tuberculosis.

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Two Adhesive Systems-effect on Adhesion to Tooth Structure

Revista de Chimie ◽

10.37358/rc.19.7.7389 ◽

2019 ◽

Vol 70 (7) ◽

pp. 2608-2613

Author(s):

Larisa Simona Deac ◽

Kamel Earar ◽

Adela Loredana Colceriu Burtea ◽

Alexandra Stefania Berghe ◽

Aurora Antoniac ◽

...

Keyword(s):

Adhesive Systems ◽

Hybrid Layer ◽

Tooth Structure ◽

Selective Etch ◽

Etch And Rinse ◽

Significant Difference ◽

Wisdom Teeth ◽

Group 2 ◽

Self Etch ◽

Group 1

This study evaluates and compares by dye penetration method and SEM photomicrographs the sealing obtained using two different classes of adhesive systems (etch-and-rinse and self-etch with selective etching) with SDR (Dentsply) bulk fill composite. 84 class V cavities were prepared on oral and vestibular face of 42 intact, freshly extracted wisdom teeth. The cavities were randomly divided in two groups and restored: Group 1 with prime &bond one select (Dentsply) and SDR (Dentsply) and Group 2 with prime&bond one Etch&Rinse (Dentsply) and SDR (Dentsply). Prime&bond one Select (Dentsply) is a single component adhesive and can be used in self etch mode, in selective enamel etch mode, or in etch-and-rinse mode. We chosen for this study the selective etch of the enamel mode. Prime&bond one Etch Rinse (Dentsply) is a universal etch-and-rinse one-bottle dental adhesive, designed to be used in two steps. The bulk fill composites are commonly used in modern dentistry due to their properties of low polymerization shrinkage and curing in layer of 4 mm depth, offering the practitioner a fast clinical procedure with good results. The results showed a good sealing at enamel and dentin margins with no statistically significant difference between adhesives, even though the mean of enamel infiltration was smaller for Group1. Furthermore the results show that there were differences between the two groups, for the infiltrations at the enamel, the values of microleakage being arithmetically higher for Group 1, but with no statistically difference between the two groups.SEM images showed for both groups a good adhesion surface with the tooth, but the hybrid layer of the total-etch adhesives is different from the hybrid layer formed by self etch adhesives, in terms of thickness, uniformity. In conclusion both adhesive systems have equivalent sealing qualities and can be successfully used with SDR.

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Reducing Gingivitis Remotely using the iGAM mHealth app (part 2): Prospective Observational Study (Preprint)

10.2196/preprints.24955 ◽

2020 ◽

Author(s):

Guy Tobias ◽

Assaf B Spanier

Keyword(s):

Oral Health ◽

Tooth Loss ◽

Prospective Observational Study ◽

Dental Clinics ◽

Significant Difference ◽

Observational Cohort ◽

Group 2 ◽

And Behavior ◽

Oral Hygiene Habits ◽

Group 1

BACKGROUND Gingivitis is a non-painful, inflammatory condition that can be treated with home remedies. Left untreated gingivitis can lead to tooth loss. Periodic dental examinations are important for early diagnosis and treatment of gum diseases. In order to contain the spread of the corona virus, governments, including in Israel, have restricted movements of their citizens which has caused routine dental checkups to be postponed. OBJECTIVE This study aimed to examine the ability of an mHealth app- iGAM to reduce gingivitis. METHODS A prospective observational cohort study was performed, 160 unpaid participants were divided into 2 equal groups and downloaded the iGAM app. Group 1 photographed their gums weekly for eight weeks. Group 2 photographed their gums at the time of recruitment and 8 weeks later. After photo submission, the participants received the message "It is recommended to read the information contained within the app regarding maintaining oral hygiene habits". A single blinded researcher examined the images and scored them according to the Modified Gingival Index (MGI). RESULTS The average age of group 1 was 26.77 (S.D. ± 7.43), and 28.53 (S.D. ± 10.44) for group 2. The majority were male (74.7% in group 1 vs. 66.7% in group 2), most participants described themselves as "secular", most were "single", non-smokers (74.7% vs. 78.4%) and did not take medications (85.3% vs. 78.4%). 126 subjects completed the study. A statistically significant difference (P <.001) was found in the dependent variable (MGI) in a linearly negative manner. As time passed, the gum condition improved, there were significantly lower gingivitis scores in group 1 (M = 1.16, S.D. ± 1.18) compared to group 2 (M = 2.16, S.D. ± 1.49), after eight weeks. Those with more recent dental visits had a lower MGI (p = .037). No association was found between knowledge and behavior, most participants were familiar with the recommendations for maintaining oral health, yet they only performed some. CONCLUSIONS A dental selfie taken once a week using an mHealth app (iGAM) reduced the signs of gingivitis and promoted oral health. During the current pandemic where social distancing recommendations may be causing people to avoid dental clinics, this app can remotely promote gum health. CLINICALTRIAL The protocol was approved by Hadassah research ethics committee (IRB, 0212-18-HMO)

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Scanning Electron Microscopy Analysis of the Anterior Capsulotomy Edge: A Comparative Study between Femtosecond Laser-Assisted Capsulotomy and Manual Capsulorhexis

Journal of Ophthalmology ◽

10.1155/2018/8620150 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Daniele Tognetto ◽

Chiara De Giacinto ◽

Alberto Armando Perrotta ◽

Tommaso Candian ◽

Alessandro Bova ◽

...

Keyword(s):

Electron Microscopy ◽

Scanning Electron Microscopy ◽

Femtosecond Laser ◽

Comparative Study ◽

Surface Irregularity ◽

Significant Difference ◽

Group 2 ◽

Cut Surface ◽

Scanning Electron ◽

Group 1

Purpose. To compare the capsule edges ultrastructure obtained by two femtosecond laser-assisted cataract surgery (FLACS) platforms and manual continuous curvilinear capsulorhexis (CCC) using scanning electron microscopy (SEM). Setting. Eye Clinic, University of Trieste, Italy. Design. Experimental comparative study. Methods. 150 anterior capsules were collected and divided into three groups as follows: Group 1 (50 capsules) obtained with manual CCC, Groups 2 and 3 (each with 50 capsules) obtained with the Catalys Laser and the LenSx Laser, respectively. All samples were imaged by means of SEM and regularity of the cut surface, and thickness of the capsule edge were evaluated and compared. Results. All femtosecond laser (FSL) capsules were perfectly circular, whereas some alteration of the circular shape was observed in the manual ones. Group 1 showed a smooth and regular capsule edge without any surface irregularity, conversely Groups 2 and 3 showed postage-stamp perforations on the capsule edge. The cut surface irregularity value in Group 2 was 1.4 ± 0.63, while it was 0.7 ± 0.49 in Group 3 (p<0.05). Group 1 had a significantly lower thickness of the capsule edge than the FSL groups (p<0.05). No statistically significant difference in the capsule edge thickness between the FSL groups was found (p=0.244). Conclusions. Despite the presence of slight cut surface irregularities, both FSL capsulotomies showed a better geometry and circularity than the manual ones. Capsulotomy specimens obtained using both FSL capsulotomies showed laser-induced alterations of the capsule edge when compared with smooth and regular edges obtained using manual CCC.

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Isometric Handgrip Exercise Training Improves Spirometric Parameters and Pulmonary Capacity

Pathophysiology ◽

10.3390/pathophysiology28030022 ◽

2021 ◽

Vol 28 (3) ◽

pp. 328-338

Author(s):

Ogbutor Udoji Godsday ◽

Nwangwa Eze Kingsley ◽

Nwogueze Bartholomew Chukwuebuka ◽

Chukwuemeka Ephraim ◽

Ezunu Emmanuel ◽

...

Keyword(s):

Pulmonary Function ◽

Isometric Exercise ◽

Handgrip Exercise ◽

Isometric Handgrip ◽

Post Exercise ◽

Significant Difference ◽

Isometric Handgrip Exercise ◽

Group 3 ◽

Group 2 ◽

Group 1

Decline in normal physiological pulmonary function has been attributed to premorbid conditions such as prehypertension. Research evidence suggests that physical activity reduces age-related decline in pulmonary function and improves the efficiency of the lungs in prehypertensive patients. However, there is a scarcity of data evidence relating to isometric exercise and pulmonary function. Furthermore, the interrelationship between the intensity and duration of isometric exercise and pulmonary function in these patients is still uncertain. Therefore, this study was undertaken to investigate the effect of isometric handgrip exercise on pulmonary function capacity in adults with prehypertension. To determine the effectiveness of isometric handgrip exercise on pulmonary function capacity in adults with prehypertension. A quasi experiment using a pre- and post-exercise method was carried out in two out-patients hospital settings. The sample comprised 192 sedentary pre-hypertensive subjects, aged between 30–50 years, that were randomly distributed into three groups of 64 participants each. The subjects performed, for 24 consecutive days, an isometric handgrip exercise at 30% Maximum Voluntary Contraction (M.V.C.). At the end of the 24 days, group one (GP1) discontinued, while group two (GP2) continued the exercise protocol for another 24 consecutive days and group three (GP3) continued with the exercise protocol for another 24 consecutive days but at 50% M.V.C. Determinants of lung function (outcomes) were Forced Expiratory Volume in 1 s (FEV1), Forced Vital Capacity (FVC), FEV1/FVC Ratio and Peak Expiratory Flow Rate (PEFR). The study shows that there was no statistically significant difference in the pre- and post-exercise outcomes for FEV1, FVC, FEV1/FVC Ratio and PEFR after 24 days for group 1. In group 2, there was a statistically significant difference in the FVC [(mean = 0.12 ± 0.12), (p = 0.002)], FEV1 [(mean = 0.15 ± 0.17), (p = 0.003)] and PEF [(mean = 0.85 ± 0.35), (p = 0.001)] after 48 days. In group 3, there was a statistically significant difference (p = 0.001) in all the outcomes assessed after 48 days. There was a between groups difference in favour of group 2 compared with group 1 for outcomes of FEV1 [(mean = 0.142 ± 0.68), (p = 0.005)] and PEF [(mean = 0.83 ± 0.19), (p = 0.0031)]. There was statistically significant difference in favour of group 3 compared to group 2, by increasing the exercise intensity from 30% to 50% M.V.C., for outcomes of FVC [mean change = 0.10 ± 0.052), (p = 0.005)], FEV1/FVC [mean change = 3.18 ± 0.75), (p = 0.017)] and PEF [(mean change = 0.86 ± 0.35), (p = 0.001)] after 48 days. Isometric handgrip exercise (after 48 days at 30% to 50% M.V.C.) improves outcomes of pulmonary function capacity in adults with prehypertension. Meanwhile, duration and/or increase in intensity of the isometric effort significantly contributed to the affects attained.

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