scholarly journals Safety of Exercise Testing in the Clinical Chinese Population

2021 ◽  
Vol 8 ◽  
Author(s):  
Yaoshan Dun ◽  
Thomas P. Olson ◽  
Jeffrey W. Ripley-Gonzalez ◽  
Kangling Xie ◽  
Wenliang Zhang ◽  
...  
Keyword(s):  
Adverse Events ◽  
Confidence Interval ◽  
Exercise Testing ◽  
Chinese Population ◽  
Clinical Symptoms ◽  
Cardiopulmonary Exercise Testing ◽  
Safety Data ◽  
Cross Sectional Study ◽  
Exercise Tests ◽  
Cross Sectional

This 18-year cross-sectional study was conducted to provide data on the safety of exercise testing in the clinical Chinese population. We retrospectively identified exercise tests completed at Xiangya Hospital of Central South University from January 1, 2002 to December 31, 2019. From 43,130 unique individuals (50.9% female), a total of consecutive 50,142 tests (standard exercise testing 29,466; cardiopulmonary exercise testing 20,696) were retrieved. Demographics, patients' medical history, exercise testing characteristics, and exercise testing-related adverse events were described. Safety data is expressed as the number of adverse events per 10,000 tests, with 95% confidence interval. The average patients' age was 51 ± 13 years. The majority of patients were diagnosed with at least one disease (N = 44,941, 89.6%). Tests were maximal or symptom-limited. Common clinical symptoms included dizziness (6,822, 13.6%), chest pain or distress (2,760, 5.5%), and musculoskeletal limitations (2,507, 5.0%). Out of 50,142 tests, three adverse events occurred, including one sustained ventricular tachycardia, one sinus arrest with junctional escape rhythm at a rate of 28 bpm, and one syncopal event with fecal and urinary incontinence. The rate of adverse events was 0.8 events per 10,000 tests (95% confidence interval, 0.2–3.0) in men, 0.4 per 10,000 tests (0.7–2.2) in women, and 0.6 per 10,000 tests (0.21.8) total. This study represents the largest dataset analysis of exercise testing in the clinical Chinese population. Our results demonstrate that clinical exercise testing is safe, and the low rate of adverse events related to exercise testing might be due to the overall changes in clinical practice over time.

scholarly journals Measures of excess $$ \dot{\mathrm{V}} $$CO2 and recovery $$ \dot{\mathrm{V}} $$CO2 as indices of performance fatigability during exercise: a pilot study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Liana C. Wooten ◽  
Brian T. Neville ◽  
Randall E. Keyser
Keyword(s):  
Pilot Study ◽  
Adverse Events ◽  
Exercise Testing ◽  
Cardiopulmonary Exercise Testing ◽  
Work Rate ◽  
Cross Sectional ◽  
Muscle Energetics ◽  
Testing Procedures ◽  
Severity Scores ◽  
And Performance

Abstract Background The severity of performance fatigability and the capacity to recover from activity are profoundly influenced by skeletal muscle energetics, specifically the ability to buffer fatigue-inducing ions produced from anaerobic metabolism. Mechanisms responsible for buffering these ions result in the production of excess carbon dioxide (CO2) that can be measured as expired CO2 ($$ \dot{\mathrm{V}} $$ V ̇ CO2) during cardiopulmonary exercise testing (CPET). The primary objective of this study was to assess the feasibility of select assessment procedures for use in planning and carrying out interventional studies, which are larger interventional studies investigating the relationships between CO2 expiration, measured during and after both CPET and submaximal exercise testing, and performance fatigability. Methods Cross-sectional, pilot study design. Seven healthy subjects (30.7±5.1 years; 5 females) completed a peak CPET and constant work-rate test (CWRT) on separate days, each followed by a 10-min recovery then 10-min walk test. Oxygen consumption ($$ \dot{\mathrm{V}} $$ V ̇ O2) and $$ \dot{\mathrm{V}} $$ V ̇ CO2 on- and off-kinetics (transition constant and oxidative response index), excess-$$ \dot{\mathrm{V}} $$ V ̇ CO2, and performance fatigability severity scores (PFSS) were measured. Data were analyzed using regression analyses. Results All subjects that met the inclusion/exclusion criteria and consented to participate in the study completed all exercise testing sessions with no adverse events. All testing procedures were carried out successfully and outcome measures were obtained, as intended, without adverse events. Excess-$$ \dot{\mathrm{V}} $$ V ̇ CO2 accounted for 61% of the variability in performance fatigability as measured by $$ \dot{\mathrm{V}} $$ V ̇ O2 on-kinetic ORI (ml/s) (R2=0.614; y = 8.474x − 4.379, 95% CI [0.748, 16.200]) and 62% of the variability as measured by PFSS (R2=0.619; y =  − 0.096x + 1.267, 95% CI [−0.183, −0.009]). During CPET, $$ \dot{\mathrm{V}} $$ V ̇ CO2 -off ORI accounted for 70% (R2=0.695; y = 1.390x − 11.984, 95% CI [0.331, 2.449]) and $$ \dot{\mathrm{V}} $$ V ̇ CO2 -off Kt for 73% of the variability in performance fatigability measured by $$ \dot{\mathrm{V}} $$ V ̇ O2 on-kinetic ORI (ml/s) (R2=0.730; y = 1.818x − 13.639, 95% CI [0.548, 3.087]). Conclusion The findings of this study suggest that utilizing $$ \dot{\mathrm{V}} $$ V ̇ CO2 measures may be a viable and useful addition or alternative to $$ \dot{\mathrm{V}} $$ V ̇ O2 measures, warranting further study. While the current protocol appeared to be satisfactory, for obtaining select cardiopulmonary and performance fatigability measures as intended, modifications to the current protocol to consider in subsequent, larger studies may include use of an alternate mode or measure to enable control of work rate constancy during performance fatigability testing following initial CPET.

scholarly journals Overshoot of the Respiratory Exchange Ratio during Recovery from Maximal Exercise Testing in Kidney Transplant Recipients

2021 ◽  
Vol 18 (17) ◽  
pp. 9236
Author(s):  
Alessandro Patti ◽  
Daniel Neunhaeuserer ◽  
Andrea Gasperetti ◽  
Veronica Baioccato ◽  
Marco Vecchiato ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Exercise Testing ◽  
Respiratory Exchange Ratio ◽  
Cardiopulmonary Exercise Testing ◽  
Cross Sectional Study ◽  
Peak Exercise ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Cross Sectional ◽  
Linear Slope

The overshoot of the respiratory exchange ratio (RER) during recovery from exercise has been found to be reduced in magnitude among patients with heart failure. The aim of this study is to investigate whether this phenomenon could also be present in patients with peripheral, and not cardiac, limitations to exercise such as kidney transplant recipients (KTRs). In this retrospective cross-sectional study, KTRs were evaluated with maximal cardiopulmonary exercise testing (CPET) assessing the RER overshoot parameters during recovery: the RER at peak exercise, the maximum RER value reached during recovery, the magnitude of the RER overshoot (RER mag = (RER max-peak RER)/peak RER%) and the linear slope of the RER increase after the end of exercise. A total of 57 KTRs were included in the study (16 females), all of them showing a significant RER overshoot (RER mag: 28.4 ± 12.7%). Moreover, the RER mag showed significant correlations with the fitness of patients (peak VO2: ρ = 0.57, p < 0.01) and cardiorespiratory efficiency (VE/VCO2 slope: r = −0.32, p < 0.05; oxygen uptake efficiency slope (OUES): r = 0.48, p < 0.01). Indeed, the RER mag was significantly different between the subgroups stratified by Weber’s fitness class or a ventilatory efficiency class. Our study is the first to investigate recovery of the RER in a population of KTRs, which correlates well with known prognostic CPET markers of cardiorespiratory fitness, determining the RER mag as the most meaningful RER overshoot parameter. Thus, the RER recovery might be included in CPET evaluations to further improve prognostic risk stratifications in KTRs and other chronic diseases.

scholarly journals Impaired functional and hemodynamic response to graded exercise testing and its recovery in patients with subclinical hyperthyroidism

2011 ◽  
Vol 55 (3) ◽  
pp. 203-212 ◽  
Author(s):  
Patrícia dos Santos Vigário ◽  
Dhiãnah Santini de Oliveira Chachamovitz ◽  
Patrícia de Fátima dos Santos Teixeira ◽  
Mauro Augusto dos Santos ◽  
Fátima Palha de Oliveira ◽  
...  
Keyword(s):  
Exercise Testing ◽  
Cardiopulmonary Exercise Testing ◽  
Exercise Duration ◽  
Cross Sectional Study ◽  
Suppressive Therapy ◽  
Subclinical Hyperthyroidism ◽  
Hemodynamic Responses ◽  
Cross Sectional ◽  
Hemodynamic Variables ◽  
Response To Exercise

OBJECTIVE: To evaluate the functional and hemodynamic responses during exercise and its recovery in patients with subclinical hyperthyroidism (SCH). SUBJECTS AND METHODS: A cross-sectional study was carried out with 29 patients on TSH-suppressive therapy with levothyroxine for thyroid carcinoma and 35 euthyroid subjects. All volunteers underwent a cardiopulmonary exercise testing on a treadmill and functional and hemodynamic variables were measured during exercise and its recovery. RESULTS: SCH patients showed impaired functional response to exercise, marked by lower values for oxygen consumption and exercise duration in addition to premature achievement of the anaerobic threshold. Heart-rate and blood pressure recovery immediately after exercise were slower among SCH patients when compared to euthyroid subjects. CONCLUSION: SCH is associated with impaired functional and hemodynamic responses during exercise and its recovery.

CLINICAL SYMPTOMS, BIOCHEMISTRY AND CYTOLOGY OF PLEURAL, PERITONEAL EFFUSIONS

2016 ◽  
pp. 66-71
Author(s):  
Van Mao Nguyen ◽  
Huyen Quynh Trang Pham
Keyword(s):  
Pleural Effusion ◽  
Clinical Symptoms ◽  
Cross Sectional Study ◽  
Malignant Cells ◽  
Sectional Study ◽  
Pleural Effusions ◽  
Cross Sectional ◽  
Breath Sounds ◽  
Peritoneal Effusion ◽  
Neutrophil Leukocytes

Background: The cytology and the support of clinical symptoms, biochemistry for diagnosis of the cases of effusions are very important. Objectives: - To describe some of clinical symptoms and biochemistry of effusions. - To compare the results between cytology and biochemistry by the causes of pleural, peritoneal fluids. Material & Method: A cross-sectional study to describe all of 47 patients with pleural, peritoneal effusions examinated by cytology in the Hospital of Hue University of Medicine and Pharmacy from April 2013 to January 2014. Results: In 47 cases with effusions, pleural effusion accounting for 55.32%, following peritoneal effusions 29.79% and 14.89% with both of them. The most common symptoms in patients with pleural effusions were diminished or absent tactile fremitus, dull percussion, diminished or absent breath sounds (100%), in patients with peritoneal effusions was ascites (95.24%). 100% cases with pleural effusions, 50% cases with peritoneal effusions and 80% cases with pleural and peritoneal effusions were exudates. The percentage of malignant cells in patients with pleural effusions was 26.92%, in peritoneal effusions was 28.57%, in pleural and peritoneal effusions was 42.86%. The percentage of detecting the malignant cells in patients with suspected cancer in the first test was 57.14%, in the second was 9.53% and 33.33% undetectable. Most of cases which had malignant cells and inflammatory were exudates, all of the cases which had a few cells were transudates. Besides, 7.5% cases which had high neutrophil leukocytes were transudates. Conclusion: Cytology should be carry out adding to the clinical examinations and biochemistry tests to have an exact diagnosis, especially for the malignant ones. For the case with suspected cancer, we should repeat cytology test one more time to increase the ability to detect malignant cells. Key words: Effusion, pleural effusion, peritoneal effusion, cytology, biochemistry

Prevalence of COVID-19-like Symptoms among People Living with HIV, and Using Antiretroviral Therapy for Prevention and Treatment

2020 ◽  
Vol 18 (5) ◽  
pp. 373-380 ◽  
Author(s):  
SeyedAhmad SeyedAlinaghi ◽  
Maryam Ghadimi ◽  
Mahboubeh Hajiabdolbaghi ◽  
Mehrnaz Rasoolinejad ◽  
Ladan Abbasian ◽  
...  
Keyword(s):  
Respiratory Symptoms ◽  
Antiretroviral Treatment ◽  
Clinical Symptoms ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Shortness Of Breath ◽  
Sectional Study ◽  
Limited Data ◽  
Cross Sectional ◽  
Living With Hiv

Background: COVID-19 has spread globally with remarkable speed, and currently, there is limited data available exploring any aspect of the intersection between HIV and SARSCoV- 2 co-infection. Objective: To estimate the prevalence of clinical symptoms associated with COVID-19 among people living with HIV (PLWH) in Tehran, Iran. Design: Cross-sectional study. Methods: A total of 200 PLWH were recruited through the positive club via sampling, and completed the symptom-based questionnaire for COVID-19, which was delivered by trained peers. Results: Of 200 participants, respiratory symptoms, including cough, sputum, and shortness of breath, were the most prevalent among participants, but only one person developed symptoms collectively suggested COVID-19 and sought treatments. Conclusions: It appears that existing infection with HIV or receiving antiretroviral treatment (ART) might reduce the susceptibility to the infection with SARS-CoV-2 or decrease the severity of the infection acquired. Further research is needed to understand causal mechanisms.

scholarly journals Combined effect of hypertension and hyperuricemia on ischemic stroke in a rural Chinese population

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Peng Sun ◽  
Mengqi Chen ◽  
Xiaofan Guo ◽  
Zhao Li ◽  
Ying Zhou ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Missing Data ◽  
Chinese Population ◽  
Joint Effect ◽  
Cross Sectional Study ◽  
Combined Effect ◽  
Sectional Study ◽  
Cross Sectional ◽  
Current Smoking ◽  
Positive Correlations

Abstract Background To investigate the combined effect of hypertension and hyperuricemia to the risk of ischemic stroke in a rural Chinese population. Methods The cross-sectional study was conducted from 2012 to 2013 in a rural area of China. After exclusion for missing data, we finally included 11,731 participants into analysis. Results After adjusting for age, current smoking, current drinking, BMI, TG, HDL-C and eGFR, hypertension was significantly associated with ischemic stroke in men (OR: 2.783, 95% CI: 1.793, 4.320) and in women (OR: 4.800, 95% CI: 2.945, 7.822). However, hyperuricemia was significantly associated with ischemic stroke only in women (OR: 1.888, 95% CI: 1.244, 2.864). After full adjustment, participants with both hypertension and hyperuricemia had 8.9 times higher risk than those without them. Finally, the interaction between hypertension and hyperuricemia was statistically significant only in women rather than in men after full adjustment. Conclusions This study demonstrated the positive correlations between hypertension, hyperuricemia and ischemic stroke. Our study also demonstrated the joint effect between hypertension and hyperuricemia towards ischemic stroke only in women, not in men.

scholarly journals Characteristics of Pruritus in Various Clinical Variants of Psoriasis: Results of the Multinational, Multicenter, Cross-Sectional Study

Life ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 623
Author(s):  
Kamila Jaworecka ◽  
Dominika Kwiatkowska ◽  
Luiza Marek ◽  
Funda Tamer ◽  
Aleksandra Stefaniak ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Cross Sectional Study ◽  
Pustular Psoriasis ◽  
Cross Sectional ◽  
Large Plaque ◽  
Scalp Psoriasis ◽  
Generalized Pustular Psoriasis ◽  
Itch Sensation ◽  
Clinical Variants ◽  
Subtype A

Psoriasis is a chronic, inflammatory skin disease present in about 3% of the world’s population. The clinical symptoms manifest diversely, therefore one can distinguish several subtypes of psoriasis. The majority of patients with psoriasis experience pruritus, which is an unpleasant sensation that decreases patients’ quality of life. The knowledge on pruritus in different subtypes of psoriasis is limited. We have performed a cross-sectional, prospective, and multicenter study to evaluate the relationship between clinical subtypes of psoriasis (large-plaque, nummular, guttate, palmoplantar, inverse, erythrodermic, palmoplantar pustular, generalized pustular psoriasis, and psoriasis of the scalp) and the prevalence, intensity, and clinical manifestation of itch. We introduced a questionnaire assessing various aspects of pruritus to a total of 254 patients. Out of these, 42 were excluded. Pruritus was present in 92.9% of the remaining patients and its prevalence did not depend on the clinical subtype. A correlation between the severity of psoriasis and the intensity of itch was explicitly noticeable in palmoplantar pustular psoriasis and scalp psoriasis (p < 0.05). The itch sensation was individual and differed among subtypes of psoriasis. In conclusion, pruritus is a frequent phenomenon, and its presentation is different in various subtypes of psoriasis.

scholarly journals Rubella Outbreak in Heballi Agasi Ward, Dharwad District, Karnataka, India, 2014–2015

2020 ◽  
Vol 41 (S1) ◽  
pp. s380-s380
Author(s):  
Sree Kalpana Mohankumar ◽  
Vishweshwarayya Hiremath ◽  
Rajashree Koppad
Keyword(s):  
Attack Rate ◽  
Clinical Symptoms ◽  
Cross Sectional Study ◽  
Routine Immunization ◽  
Serum Samples ◽  
Cross Sectional ◽  
Epidemic Curve ◽  
Surveillance Report ◽  
And Gender ◽  
Rubella Vaccination

Background: Countries that have good rubella surveillance, report ∼10,000–20,000 rubella cases annually. In India, not many cases of rubella are reported. The Hebballi Agasi ward of Dharwad district in Karnataka state, India, reported rubella cases on the last week of January 2015. Objective: We investigated the outbreak by time, place, person, and clinical symptoms. Methods: We performed a cross-sectional study. We defined a case as any resident of Heballi Agasi who had fever and rash, with or without lymphadenopathy, arthralgia, conjunctivitis, coryza, and cough, after December 15, 2014. We collected sociodemographic details and clinical symptoms of patients. We collected 5 serum samples and sent them to the National Measles Laboratory, Bangalore. We tested for measles and rubella antibodies. We drew an epidemic curve and a spot map. We computed mean age of cases, and we calculated attack rates by mean age and gender. We calculated proportions to describe clinical symptoms, and we interviewed stakeholders regarding rubella vaccination. We continued surveillance until March 2015. Results: The population of Heballi Agasi was 1,458. We identified 15 rubella cases (9 girls and 6 boys). The outbreak lasted between December 10, 2014, and February 21, 2015, with a peak on January 16, 2015. The overall attack rate was 1% (15 of 1,458). The mean age of the cases was 6 years (range, 1–23). The attack rate was high (7.7%) among those aged 1–6 years (11 of 143). The attack rate among those aged >6 years was 0.3% (4 of 1,315). In addition to fever and rash, 93% of cases (14 of 15) had coryza, 47% had cough (7 of 15), and 40% had conjunctivitis (6 of 15). Lymphadenopathy was present in only 1 case (1 of 15), and arthralgia was absent among all 15 cases. There was no death among the cases. All 5 sera were positive for rubella and negative for measles. Rubella vaccination was not given for any of the cases because no rubella vaccination is provided in the routine immunization program. Conclusions: There was a rubella outbreak in Heballi Agasi ward. Children aged 1–6 years were most affected. We recommend rubella vaccination in the routine immunization.Funding: NoneDisclosures: None

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