Is there a beneficial effect difference between age, gender, and different cardiac pathology groups of exercise training at ventilatory threshold in cardiac patients?

Background: Research on cardiac rehabilitation has raised interesting methods and effects without however establishing the share of the profits according to age, sex and cardiac pathology. Yet today, this disease with various pathologies strikes people of all ages and both sexes, and the recommended rehabilitation exercise intensity is often the ventilatory threshold. The aim of this study was to compare benefits of a training program at ventilatory threshold according to age, gender and cardiac pathology. Methods: One hundred and eighty eight cardiac patients, of whom 62 had coronary artery bypass surgery, 22 artery angioplasty, 54 myocardial infarction and 50 valve replacements, aged 31–82 years, performed spirometric and cardiopulmonary exercise tests before and after a training program. This program consisted of exercise on a cycloergometer for three sessions of 45 min per week for eight weeks at heart rates attenuated at ventilatory threshold (VTh) obtained during a cardiopulmonary exercise test conducted before the training period. Results: Peak heart rate, peak aerobic power, and peak oxygen uptake determined at VTh increased during the training period in all groups of subjects. Men and adult groups had higher absolute values compared to women and elderly groups. No difference was observed in cardiac pathology groups. Similar improvements of aerobic capacities were observed in age, gender and cardiac pathology groups. Conclusions: A training program conducted at personalised VTh significantly improves the aerobic physical capacities of all cardiac patients, and inducessimilar benefits whatever the age, gender or cardiac pathology. (Cardiol J 2011; 18, 6: 632–638

Prevalence and determinants of Leishmania major infection in emerging and old foci in Tunisia

International audienceBackground: Zoonotic Cutaneous Leishmaniasis (ZCL) due to Leishmania major (L. major) is still a serious public health problem in Tunisia. This study aimed to compare the prevalence and risk factors associated with L. major infection in old and new foci using leishmanin skin test (LST) in central Tunisia. Methods: A cross sectional household survey was carried out between January and may09 on a sample of 2686 healthy individuals aged between 5 and 65 years. We determined the prevalence of L. major infection using the LST. Risk factors of LST positivity were assessed using a logistic regression model. Results: The overall prevalence of LST positivity was 57% (95% CI: 53-59). The prevalence of L. major infection was significantly higher in the old focus (99%; 95% CI: 98-100) than in the emerging foci (43%; 95% CI: 39-46) (p = <0.001). Multivariate analysis of LST positivity risk factors showed that age, the nature of the foci (old/emerging), personal and family history of ZCL are determinants of positive LST results. Conclusion: The results updated the current epidemiologic profile of ZLC in central Tunisia. Past history of transmission in a population should be considered as a potential confounder in future clinical trials for drugs and vaccines against L. major cutaneous leishmaniasis

Effects of Walking Football During Ramadan Fasting on Heart Rate Variability and Physical Fitness in Healthy Middle-Aged Males

This study aimed to investigate the effect of a walking football (WF) program during Ramadan fasting (RF) on heart rate variability (HRV) indices, body composition, and physical fitness in middle-aged males. Thirty-one healthy sedentary men were randomized to WF ( n = 18) and control ( n = 13) groups. Both groups participated in RF. The WF group were involved in a training program (small-sided games) of three sessions a week during RF. The time and frequency domains of HRV, body composition, handgrip, lumbar strength, Modified Agility Test (MAT), and 6-minute walk test (6MWT) were measured before Ramadan (BR), during Ramadan (DR), and after Ramadan (AR). We reported that RF has significantly altered some parameters of HRV DR; the mean HR decreased while the mean RR, LF, and HF increased. WF had a significant effect on HRV and mean HR DR compared with BR and AR decreased while mean RR, HF and LF increased. DR, body mass decreased in both groups, while body mass index (BMI) decreased and lean mass increased only in WF group. Lower body mass and BMI levels were reported AR only in WF group. Physical capacity improved AR, compared with BR, only in the WF group with longer distance in 6MWT, shorter time(s) in MAT, and higher lumbar strength levels. We conclude that RF increases parasympathetic system activity. WF practice during RF is safe and might improve body composition, physical fitness, autonomic cardiac function, and physical fitness in middle-aged males

Super-spreading social events for COVID-19 transmission: evidence from the investigation of six early clusters in Bahrain

IntroductionThis study aimed to characterize six early clusters of COVID-19 and derive key transmission parameters from confirmed cases that were traced between April and June 2020 in Bahrain.MethodsPairs of “infector-infectee” allowed us to map the clusters and estimate the incubation period serial interval as the secondary attack rate. The chi-squared test, with a p-value computed using the Monte Carlo test, measured associations between categorical variables. Statistical analysis was performed using R software and the “data.tree, tidyverse” libraries.ResultsFrom 9 April to 27 June 2020, we investigated 596 individuals suspected of COVID-19, of whom 127 positive cases were confirmed by PCR and linked in six clusters. The mean age was 30.34 years (S.D. = 17.84 years). The male-to-female ratio was 0.87 (276/318), and most of the contacts were of Bahraini citizenship (511/591 = 86.5%). Exposure occurred within the family in 74.3% (411/553), and 18.9% of clusters' cases were symptomatic (23/122 = 18.9%). Mapped clusters and generations increased after 24 May 2020, corresponding to “Aid El-Fitr.” The mean incubation period was 4 days, and the mean serial interval ranged from 3 to 3.31 days. The secondary attack rate was 0.21 (95% C.I.) = [0.17–0.24].ConclusionCOVID-19 transmission was amplified due to the high number of families mixing during “Aid El Fitr” and “Ramadhan,” generating important clusters. Estimated serial intervals and incubation periods support asymptomatic transmission

Temporal Dynamics and Impact of Climate Factors on the Incidence of Zoonotic Cutaneous Leishmaniasis in Central Tunisia

Old world cutaneous leishmaniasis is a vector-borne disease occurring in rural areas of developing countries. The main reservoirs are the rodents Psammomys obesus and Meriones shawi. Zoonotic Leishmania transmission cycle is maintained in the burrows of rodents where the sand fly Phlebotomus papatasi finds the ideal environment and source of blood meals. In the present study we showed seasonality of the incidence of disease during the same cycle with an inter-epidemic period ranging from 4 to 7 years. We evaluated the impact of climate variables (rainfall, humidity and temperature) on the incidence of zoonotic cutaneous leishmaniais in central Tunisia. We confirmed that the risk of disease is mainly influenced by the humidity related to the months of July to September during the same season and mean rainfall lagged by 12 to 14 months

Mechanism of Dyspnea during Exercise in Children with Corrected Congenital Heart Disease

This study will evaluate cardiorespiratory and peripheral muscle function and their relationship with subjective dyspnea threshold after the surgical correction of congenital heart disease in children. Thirteen children with surgically repaired congenital heart disease were recruited. Each participant performed an incremental exercise test on a cycle ergometer until exhaustion. Gas exchanges were continuously sampled to measure the maximal aerobic parameters and ventilatory thresholds. The functional capacity of the subjects was assessed with a 6 min walk test. At the end of the exercise test, isokinetic Cybex Norm was used to evaluate the strength and endurance of the knee extensor muscle in the leg. Dyspnea was subjectively scored with a visual analog scale during the last 15 s of each exercise step. Oxygen consumption measured at the dyspnea score/VO2 relationship located at the dyspnea threshold, at which dyspnea suddenly increased. Results: The maximal and submaximal values of the parameters describing the exercise and the peripheral muscular performances were: VO2 Peak: 33.8 &plusmn; 8.9 mL&middot;min&minus;1&middot;kg&minus;1; HR: 174 &plusmn; 9 b&middot;min&minus;1; VEmax: 65.68 &plusmn; 15.9 L&middot;min&minus;1; P max: 117 &plusmn; 27 W; maximal voluntary isometric force MVIF: 120.8 &plusmn; 41.9 N/m; and time to exhaustion Tlim: 53 &plusmn; 21 s. Oxygen consumption measured at the dyspnea threshold was related to VO2 Peak (R2 = 0.74; p &lt; 0.01), Tlim (R2 = 0.78; p &lt; 0.01), and the distance achieved during the 6MWT (R2 = 0.57; p &lt; 0.05). Compared to the theoretical maximal values for the power output, VO2, and HR, the surgical correction did not repair the exercise performance. After the surgical correction of congenital heart disease, exercise performance was impeded by alterations of the cardiorespiratory function and peripheral local factors. A subjective evaluation of the dyspnea threshold is a reliable criterion that allows the prediction of exercise capacity in subjects suffering from congenital heart disease

Contraintes ventilatoires à l'exercice chez l'obèse (effets de l'entraînement)

Les principales complications respiratoires de l obésité sont une demande accrue de ventilation, une augmentation du travail respiratoire, l inefficacité des muscles respiratoires et une diminution de la compliance respiratoire. Ces personnes présentent également une aggravation de la dyspnée et une diminution de la capacité d effort, éléments essentiels à la qualité de vie. Notre étude montre une que l exercice physique induit l installation de contraintes ventilatoires caractérisé par une augmentation du travail respiratoire, diminution de la force des muscles inspiratoires, altération de la performance des muscles inspiratoire, une dyspnée d effort et une distension pulmonaire dynamique à l exercice physique. Ces résultats sont donc en faveur de l existence d un cercle vicieux du déconditionnement chez ces sujets et ce d autant plus que leur activité physique était corrélé à leur tolérance à l effort. Ces observations justifient ainsi la prescription d un réentraînement pour améliorer la tolérance à l effort et la qualité de vie des sujets obèses. Nous avons montrés que le réentraînement à l effort améliore la tolérance à l effort, la performance des muscles inspiratoires et diminue la dyspnée d effort. En conclusion, les sujets obèses présentent des contraintes ventilatoires à l exercice constituant un facteur limitant à l exercice, le réentraînement à l effort chez les obèses constitue un traitement pertinent pour améliorer la tolérance à l effort et la qualité de vie des sujets obèses et permettre ainsi de freiner l évolution de la maladie vers l invalidité et le handicap psychosocialThe major respiratory complications of obesity include a heightened demand for ventilation, elevated work of breathing, respiratory muscle inefficiency and diminished respiratory compliance. Obese patients have increased dyspnoea and decreased exercise capacity, which are vital to quality of life. Our study shows that physical exercise is accompanied by an increased work of breathing, weakness of the inspiratory muscles, alteration of the inspiratory muscle performance, dyspnea of and a dynamic hyperinflation. Thus, these results are in favor of the existence of a vicious circle of deconditioning in these subjects and particularly as their physical activity were correlated with their exercise tolerance. These observations justify the prescription of endurance training to obese subjects to improve the exercise tolerance and the quality of life. Our results demonstrate that training improves exercise tolerance, performance of the inspiratory muscles and decrease dyspnoea. In conclusion, the obese subject present ventilatory constraints during exercise constituting a limitant factor to exercise, training improve exercise tolerance and the quality of life inducing a possible slow down to the evolution of the disease towards disability and psychosocial handicap in obese subjectsAMIENS-BU Lettres (800212104) / SudocSudocFranceF