The effects of baseline heart rate recovery normality and exercise training protocol on heart rate recovery in patients with heart failure

Objective: It is unclear which exercise training protocol yields superior heart rate recovery (HRR) improvement in heart failure (HF) patients. Whether baseline HRR normality plays a role in the improvement is unknown. We hypothesized that an exercise training protocol and baseline HRR normality would be factors in altering HRR in HF patients. Methods: In this prospective, randomized, controlled and 3 group parallel study, 41 stable HF patients were randomly assigned to 3-timesweekly training sessions for 12 weeks, consisting of i) 30 minutes of interval training (IT) (n=17, 63.7±8.8 years old) versus ii) 30 minutes of continuous training (CT) (n=13, 59.6±6.8 years old) versus iii) no training (CON) (n=11, 60.6±9.9 years old). Each patient had cardiopulmonary exercise testing before and after the training program. Maximum heart rates attained during the test and heart rates at 1 and 2 min (HRR1 and HRR2) during the recovery phase were recorded. Paired samples t-test or Wilcoxon signed-rank test was used for comparisons before and after training. One-way ANOVA or Kruskal-Wallis variance analysis was used for comparisons among groups. Results: HRR1 was unchanged after training. HRR2 improved in the IT group after training, and post-training HRR2 values were significantly faster in the IT group than in controls. Both HRR1 and HRR2 was significantly faster, irrespective of exercise protocol in patients with abnormal baseline values after training. Conclusion: HRR1 did not improve after training. HRR2 improved only in the IT group. Both HRRs in patients with abnormal baseline values improved after both exercise protocols. IT might be superior to CT in improving HRR2. Baseline HRR might play a role in its response to exercise. © 2015 by Turkish Society of Cardiology

The effect of a 6-week land and resistance training of 13-16 years old swimmers groups to lower limb isokinetic strength values and to swimming performance13-16 yaş grubu yüzücülerde 6 haftalık kara ve direnç antrenmanlarının alt ekstremite izokinetik kuvvet performansına ve yüzme derecelerine etkisi

The aim of this study is to investigate the effect of a 6-week land and resistance training of 13-16 year old swimmers groups to lower limb isokinetic strength values and to swimming performance. 22 swimmers participated in this study. The subjects were divided into three groups (A-B-C) according to their 50m swimming degrees. 25m underwater,25m,50m,75m and 100m freestyle swimming degrees of swimmers were recorded. As isokinetic measurements was applied at 60°/s,180°/s and 240°/s speed and the right and left knee. Kruskal-Wallis is used the differences between groups, the Mann-Whitney U test is used for which group the difference is caused and group differences were analyzed with the Wilcoxon test. Statistically significant difference was found between pre-test and post-test of 25m underwater,25m,50m,75m and 100m freestyle swimming values (p<0.05). In all groups, at 60°/s,180°/s,240°/s, for the right and left knee flexors and extensor, and freestyle swimming degrees positive development is observed. After 6-weeks training, isokinetic strength and swimming degrees of the group C increased 9.25%, whereas B has increased 8.35%. The pre-test and post-test results in 25m underwater,25m,50m,75m and 100m freestyle swimming values were statistically significant between the groups (p<0.05). In this study, it is possible to say that the land and resistance training can make a significant contribution to the performance of the force in this age group swimmer. ÖzetBu çalışmanın amacı; 13-16 yaş grubu yüzücülerde 6 haftalık kara ve direnç antrenmanlarının alt ekstremite izokinetik kuvvet değerlerine ve yüzme performansına etkisini araştırmaktır. Çalışmaya 22 yüzücü katılmıştır. Denekler 50m yüzme derecelerine göre üç gruba (A-B-C) ayrılmıştır. Yüzücülerin 25m sualtı, 25m, 50m, 75m ve 100m serbest stildeki yüzme dereceleri kayıt edilmiştir. İzokinetik ölçümler 60°/s, 180°/s ve 240°/s hızda sağ ve sol diz için uygulanmıştır. Gruplar arası farka Kruskal Wallis, farkın hangi gruptan kaynaklandığına Mann Whitney U testi, grup içi farklara ise Wilcoxon testi ile bakılmıştır. Ön test ve son test 25m sualtı, 25m, 50m, 75m ve 100m serbest yüzme değerlerinde istatistiksel olarak anlamlı fark bulunmuştur (p<0.05). Tüm grupların, 60º/s, 180º/s ve 240º/s hızda sağ ve sol diz için fleksör ve ektensörlerin tepe tork değerlerinde ve serbest yüzme derecelerinde sayısal olarak pozitif bir gelişim görülmüştür. 6 haftalık antrenman sonunda, C grubunun izokinetik kuvvet ve yüzme derecelerindeki artış (%9.25) iken, B grubunda bu değer (%8.35) çıkmıştır. Yapılan istatistiksel analiz sonucu ön test ve son test 25m sualtı, 25m, 50m, 75m ve 100m serbest yüzme değerlerinde gruplar arasında istatistiksel olarak anlamlı fark bulunmuştur (p<0.05). Bu çalışmada, bu yaş grubu yüzücülerde yapılan kara ve direnç antrenmanlarının kuvvet performansına önemli bir katkı sağlayabileceği söylenebilir

How Do Patients Understand Safety for Cardiac Implantable Devices? Importance of Postintervention Education

This study was designed to assess the effect of patient education on the knowledge of safety and awareness about living with cardiac implantable electronic devices (CIEDs) within the context of phase I cardiac rehabilitation. Methods. The study was conducted with 28 newly implanted CIED patients who were included in "education group (EG)". Patients were questioned with a survey about living with CIEDs and electromagnetic interference (EMI) before and 1month after an extensive constructed interview. Ninety-three patients who had been living with CIEDs were included in the "without education group (woEG)". Results. Patients in EG had improved awareness on topics related to physical and daily life activities including work, driving, sports and sexual activities, EMI of household items, harmful equipment, and some of the medical devices in the hospital setting (p<0.05). Patients in EG gave significantly different percent of correct answers for doing exercise or sports, using the arm on the side of CIEDs, EMI of some of the household appliances, medical devices, and all of the harmful equipment compared to woEG (p<0.05). Conclusion. It was demonstrated that a constructed education interview on safety of CIEDs and living with these devices within the context of phase I cardiac rehabilitation is important for improving the awareness of patients significantly. Thus, patients might achieve a faster adaptation to daily life and decrease disinformation and misperceptions and thus promote the quality of life after the device implantation

Turkish version of the paindetect questionnaire in the assessment of neuropathic pain: A validity and reliability study

Objectives: The aim of this study was to develop a Turkish version of the painDETECT questionnaire (PD-Q) and assess its reliability and validity. Methods: Two hundred and forty patients who were diagnosed by expert pain physicians in daily clinical practice and classified as having either neuropathic, nociceptive, or mixed pain for at least 3 months were enrolled in this study. After the usual translation process, the Turkish version of the PD-Q was administered to each participant twice with an interval of 48 hours. The Leeds Assessment of Neuropathic Symptoms and Signs (LANSS), Douleur Neuropathique en 4 questions (DN4) and a pain visual analog scale were assessed along with the PD-Q. Chronbach's α was calculated to evaluate internal consistency of the PD-Q. Intraclass correlation coefficient was calculated to examine test-retest reliability. Convergent validity was assessed by correlating the scale with LANSS and DN4. Discriminant statistics-sensitivity, specificity, Youden index, positive predictive value, negative predictive value-were also assessed. Results: A total of 240 patients with chronic pain, 80 patients in each neuropathic, nociceptive, and mixed pain group, were included in this study. Mean age of the patients was 54.1 years, and majority of the patients were female (52.9%). Chronbach's α of the Turkish version of the PD-Q was 0.81. The test-retest reliability of the Turkish version of the PD-Q was determined as 0.98 for the total score and ranged from 0.86 to 0.99 for individual items. The Turkish version of the PD-Q was possitively and significantly corralated with LANSS (r 0.89, P<0.001) and DN4 (r 0.82, P<0.001). When the two cutoff values in the original version were used, sensitivity was found 77.5% for a cutoff value ≤19, and specificity was 82.5%. Sensitivity and specificity were 90% and 67.5%, respectively, for the other cutoff value ≤12. Scores ≤12 represents a negative predictive value=87%, and scores 19≤ represents a positive predictive value=82%. When mixed pain patients were included in the neuropathic pain group, discriminant values were reduced as expected. Conclusions: The Turkish version of the PD-Q is a reliable and valid scale to be used to determine neuropathic component of chronic pain in Turkish patients. © 2013

Enzimatik olmayan yolla glikize edilen inek femur kortikal kemiğinin mekanik özelliklerinin deneysel çalışması.

The aim of this study is to investigate the deterioration in mechanical integrity of the collagen network in bovine bone with aging, which are related to fracture toughness. Age-related changes in collagen molecular structures formed by non-enzymatic glycation were examined and indentation fracture technique was used as a method for measuring the microstructural toughness of cortical bone. Microcrack propagation characteristics of bone for fragility were also studied. Young and old group of bovine cortical bone specimens were grouped into 2 as ribosylated and non-ribosylated which were rested in solutions for four weeks. Series of indentations were made on bone specimen groups for each of five masses 10g, 25g, 50g, 100g and 200g for 10 sec to detect the effect of applied indentation load. The applied load was increased to 300g, 500g, 1000g and 2000g for 10 sec to be able to make microcracks. Series of indentations were made on bone specimen groups for each of five durations 5sec, 10sec, 20sec, 30sec for 100g to study the effect of indentation duration. Specimens were examined in the wet and dry state while studying the factors effecting microhardness measurement. Microhardness values measured by 10g of load for 10sec were indifferent between the ribosylated and non-ribosylated groups in the young and old bovine bone pointing that this load is not indicative of the structural collagen changes. Loads of 25g, 50g, 100g and 200g for 10 sec were able to differ ribosylated bone from non-ribosylated bone for the young and old bovine bones. Degree of microhardness increased with increased incubation period. Microhardness of dry specimens being either ribosylated or non-ribosylated were found to be statistically higher than wet specimens in young and old bone except for 10g for 10sec. It has been shown that the calculated fracture toughness measured by the indentation method is a function of indentation load. Additionally, effect of indentation size might have resulted in a higher toughness measurement for higher indent loads with longer cracks even if the toughness is not actually higher.Methods using indentation technique has difficulty in relating the resistance to crack growth to the Mode I fracture toughness definition.Indentation fracture toughness allows sampling only one point on the R­curve methods and was not considered as successful for assessing materials with rising R­curve. Toughness is ranked incorrectly among riboslated and non-ribosylated bovine bone by this technique. Presence of extrinsic toughening mechanisms including crack bridging due to uncracked ligaments and collagen fibers were directly observed by scanning electron microscope. Ribosylated bone was found to have lower number of collagen bridging compared ton on-ribosylated bovine bone.As a summary, indentation fracture method by Vickers indentation in bone is a method for measuring the fracture toughness.Ph.D. - Doctoral Progra

Microhardness evaluation of non enzymatically glycated bovine femur cortical bone

The aim of this study is to investigate deterioration in mechanical integrity of the collagen network of bovine bone formed by non-enzymatic glycation (NEG), a process that mimics aging by microindentation technique. Methods: Young and old bovine cortical bone specimens were rested in solutions for four weeks for the process of NEG and were grouped as ribosylated and non-ribosylated. A series of indentations were made on bone specimens weekly for each of 3-masses of 50 g, 100 g and 200 g for 10 s to detect the effect of indentation load and for each of five durations of 5 s, 10 s, 20 s, 30 s for 100 g to study the effect of indentation duration. The applied load was increased to 300 g, 500 g, 1000 g and 2000 g for 10 s to be able to make microcracks. Specimens were tested in the wet and dry state to study the effects of hydration on microhardness measurement. Results: Loads of 50 g, 100 g and 200 g for 10 s were able to differ ribosylated bone from non-ribosylated bone for the young and old bovine bones. Microhardness values increased with increasing incubation period. Microhardness of dry specimens were found to be statistically higher than that of wet specimens. Presence of extrinsic toughening mechanisms including crack bridging due to uncracked ligaments and collagen fibers were directly observed by scanning electron microscope (SEM). Ribosylated bone was found to have lower number of collagen bridging compared to non-ribosylated bovine bone. Conclusion: Microhardness test by these are able to discriminate non-modified collagen structure from modified collagen. On the other hand, it is found that microindentation was not able to discriminate the degree of NEG

Microhardness evaluation of non enzymatically glycated bovine femur cortical bone

Purpose: The aim of this study is to investigate deterioration in mechanical integrity of the collagen network of bovine bone formed by non-enzymatic glycation (NEG), a process that mimics aging by microindentation technique. Methods: Young and old bovine cortical bone specimens were rested in solutions for four weeks for the process of NEG and were grouped as ribosylated and non-ribosylated. A series of indentations were made on bone specimens weekly for each of 3-masses of 50 g, 100 g and 200 g for 10 s to detect the effect of indentation load and for each of five durations of 5 s, 10 s, 20 s, 30 s for 100 g to study the effect of indentation duration. The applied load was increased to 300 g, 500 g, 1000 g and 2000 g for 10 s to be able to make microcracks. Specimens were tested in the wet and dry state to study the effects of hydration on microhardness measurement. Results: Loads of 50 g, 100 g and 200 g for 10 s were able to differ ribosylated bone from non-ribosylated bone for the young and old bovine bones. Microhardness values increased with increasing incubation period. Microhardness of dry specimens were found to be statistically higher than that of wet specimens. Presence of extrinsic toughening mechanisms including crack bridging due to uncracked ligaments and collagen fibers were directly observed by scanning electron microscope (SEM). Ribosylated bone was found to have lower number of collagen bridging compared to non-ribosylated bovine bone. Conclusion: Microhardness test by these are able to discriminate non-modified collagen structure from modified collagen. On the other hand, it is found that microindentation was not able to discriminate the degree of NEG. © 2015 World Scientific Publishing Company

Do isokinetic angular velocity and contraction types affect the predictors of different anaerobic power tests?

BACKGROUND: The purpose of this study was to investigate the most important predictor isokinetic muscle strength determined by different angular velocities and contraction types (i.e. concentric and eccentric) for selected anaerobic power tests in volleyball players. METHODS: Twenty male and ten female amateur volleyball players participated in this study. Selected anaerobic power tests included Wingate Anaerobic Test (WAnT), squat jump (SJ) and countermovement jump (CMJ). Peak torque values were obtained at 60, 120, 240°/s for concentric contraction of quadriceps (Qconc) and Hamstring (Hconc) and at 60°/s for eccentric contraction of quadriceps (Qecc) and Hconc. RESULTS: Moderate to good correlations (r:0.409 to r:0.887) were found between anaerobic tests and isokinetic data including peak torque and total work of both Hconc and Qconc at 60, 120, 240°/s and Qecc at 60°/s (P&lt;0.05). Qconc measured at each of 60, 120, 240°/s was found to be the only significant predictor for anaerobic tests in linear regression models (P&lt;0.05). Correlation coefficient s for Qconc increased with increasing velocity for each of the anaerobic tests. Correlation coefficient of Qconc was highest for CMJ followed by SJ and WAnT at the same angular velocity. As a distinctive feature, both Qecc and Hconc at 60°/s were significantly predictors for CMJ and SJ. CONCLUSIONS: Qconc peak torque was the single significant predictor for WAnT, SJ and CMJ and strength of the relation increases with increasing angular velocity. However, both Qecc and Hconc were significant indicators for CMJ and SJ. Training with higher isokinetic angular velocities and with eccentric contraction is desirable in a training program that has a goal of improving anaerobic performance in volleyball players. © 2014 Edizioni Minerva Medica

J Water Sanit Hyg Dev

A Water Safety Plan (WSP) is a preventive, risk management approach to ensure drinking water safety. The World Health Organization (WHO) guidelines place WSPs within a larger 'framework for safe drinking-water' that links WSPs to health, creating an implicit expectation that implementation of WSPs will safeguard health in areas with acceptable drinking water quality. However, many intervening factors can come between implementation of an individual WSP and ultimate health outcomes. Evaluating the impacts of a WSP, therefore, requires a much broader analysis than simply looking at health improvements. Until recently, little guidance for the monitoring and evaluation of WSPs existed. Drawing examples from existing WSPs in various regions, this paper outlines a conceptual framework for conducting an overall evaluation of the various outcomes and impacts of a WSP. This framework can provide a common basis for implementers to objectively monitor and evaluate the range of outcomes and impacts from WSPs, as well as a common understanding of the time frames within which those results may occur. As implementers understand the various outcomes and impacts of WSPs beyond health, a strong evidence base for the effectiveness of WSPs will develop, further enabling the scaling up of WSP implementation and provision of better quality water.CC999999/Intramural CDC HHS/United States2018-12-11T00:00:00Z30546865PMC6289063vault:3125