Physical activity in daily life in patients with asthma and the effect of anti-interleukin-5 therapy

Ανάλυση των πρώτων δεδομένων για την φυσική δραστηριότητα στην καθημερινή ζωή (ΦΔΚΖ) Ελλήνων ασθενών με άσθμα και σύγκριση τους με τρέχουσες σχετικές κατευθυντήριες οδηγίες και άλλα ταυτοποιημένα ωφέλιμα όρια, ανέδειξαν οριακά επίπεδα ΦΔΚΖ με σημαντικό περιθώρια βελτίωσης, ειδικά στους ασθενείς με σοβαρό άσθμα. Σε μια μη-καθιστική ομάδα ασθενών με σοβαρό άσθμα, η βιολογική θεραπεία με μεπολιζουμάμπη προσέφερε σημαντική και ουσιαστική βελτίωση στην ΦΔΚΖ.Analysis of the first data on physical activity in daily life (PADL) of Greek patients with asthma and novel comparison against current applicable guidelines and other identified beneficial thresholds, showed borderline levels of PADL with significant room for improvement, especially for patients with severe asthma. In a non-sedentary cohort of severe asthma patients, mepolizumab biological therapy conferred significant and meaningful improvements in PADL

A study of clinical and physiological relations of daily physical activity in precapillary pulmonary hypertension.

Daily physical activity is reduced in precapillary pulmonary hypertension (PH) but the underlying mechanisms are inadequately explored. We sought to investigate clinical and physiological relations of daily physical activity and profile differences between less and more active patients with precapillary PH. A prospective, cross-sectional study of 20 patients with precapillary PH who undertook a) a comprehensive clinical assessment, b) a preliminary treadmill test, c) 7-day monitoring of daily walking intensity with triaxial accelerometry and d) a personalized treadmill test corresponding to the individual patient mean daily walking intensity with real-time physiological measurements. Significant clinical correlations with individual patient mean walking intensity (1.71±0.27 m/s2) were observed for log N-terminal pro-brain natriuretic peptide (log-NTproBNP: r=-.75, p=<.001), age (r=-.70, p=.001), transfer factor for carbon monoxide %predicted (r=.51, p=0.022) and 6-minute walk distance (r=.50, p=.026). Significant physiological correlations were obtained for heart rate reserve (r=.68, p=.001), quadriceps tissue oxygenation index (Q-StO2: r=.58, p=.008), change in Q-StO2 from rest (r=.60, p=.006) and ventilatory equivalent for oxygen uptake (r=-.56, p=.013). Stepwise multiple regression analyses retained log-NTproBNP (R2=0.55), heart rate reserve (R2=0.44) and Q-StO (R2=0.13) accounting for a significant variance in individual walking intensity. Less active patients had greater physical activity-induced cardiopulmonary impairment, worse quadriceps oxygenation profile and compromised health-related quality of life compared to more active patients. These preliminary findings suggest a significant relation between right ventricular and peripheral muscle oxygenation status and reduced daily physical activity in precapillary PH. Further research is warranted to unravel the physiological determinants, establish clinical predictors, and identify beneficial interventions

Near infrared spectroscopy for the assessment of peripheral tissue oxygenation in pulmonary arterial hypertension

Pulmonary arterial hypertension (PAH) is characterised by increased pulmonary vascular resistance and results in increased morbidity and mortality due to right heart failure and a progressive decline in cardiac output [1, 2]. The latter disturbs oxygen delivery to the periphery and may lead to pathological changes in tissue oxygenation. The balance between global oxygen supply and demand is reflected in mixed venous oxygen saturation (SvO2), an index that is generally reduced in patients with PAH [3]. SvO2 at baseline is one of the strongest predictors of survival in PAH [4–6]; this is also true for changes in SvO2 during follow-up [5]. Cut-off values of 60% [7] and 65% [5] have been used to distinguish between prognostic groups suggesting that these may be suitable treatment goals. SvO2 is measured invasively in the pulmonary artery, where venous blood mixes after circulating through the superior and inferior vena cava, coronary sinuses and the right-heart chambers

Seismic design, testing and analysis of reinforced concrete wall buildings

Large investments have recently been made for the construction of new medium- and high-rise buildings in California. In many cases performance-based designs have been the preferred method for these buildings. A main consideration in performance-based seismic design is the estimation of the likely development of structural and nonstructural damage limit-states given a hazard level. For this type of buildings efficient modeling techniques are required able to compute the response at different performance states. A research work was conducted at University of California San Diego (UCSD) on the i) seismic design, ii) experimental response and iii) computational modeling of medium- and high-rise reinforced concrete wall buildings. In the first part of this work a displacement-based seismic design method for use within performance-based is developed. Capacity design is used to control the mechanism of inelastic deformation. Based on principles of plastic analysis and structural dynamics the new formulation allows the computation of the effects of system overstrength and of the higher modes of response. Equal emphasis is given to displacement, force and acceleration demand parameters. The ground motion destructiveness potential is also determined. Application of the method to reinforced concrete wall buildings is discussed. The method is validated with the experimental response of a full-scale 7 story building. In addition a dual plastic hinge design concept for improving the performance and optimizing the construction of high-rise buildings is presented. The second part presents the experimental research program, with extensive shake table tests, of a full-scale 7-story reinforced concrete wall building slice, that was conducted at UCSD. The base shear coefficient obtained by the proposed method, of the first part of the research work, described above was 50% of that required by the equivalent static method prescribed by the ASCE-7 code. In spite of the reduced amount of longitudinal reinforcing steel, all performance objectives were met. The response of the building was significantly influenced, as expected, by the interaction of the main lateral force resisting wall with other structural elements (kinematic overstrength) and by the higher modes of response. Finally the third part presents a dynamic nonlinear strut-and-tie modeling approach developed for the analysis and evaluation of damage limit-states in reinforced concrete walls. The modeling approach is verified with the response of the UCSD 7-story building tes