Corticosteroids and performance.
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Biomedical subjects
Publications and source records attributed to L Prokop.
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A general statement about the driving ability of HIV-positive as well as HIV-negative addicts undergoing methadone-substitution treatment cannot be made with certainty. Even isolated observations are not significant; only an individually performed assessment, free of prejudice and conscientiously done is decisive. The formal assertion that addiction equals driving-inability, which is largely practised at present, is inadmissible and therefore harmful to the therapeutic efforts for rehabilitation.
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Due to a well known experience physical work in patients with diabetes mellitus II is a very important part of the therapy beside diet and medicament treatment. To guarantee a high training efficiency an individual training regimen has to be worked out for the patient. To influence the impaired glucose metabolism the endurance exercise should be carried out at an intensity near the anaerobic threshold. Therefore it is necessary to have a stepwise incremental exercise test including lactate determination after each work load of the patient. Basing on exercise test this paper is designed to give an example of a training regimen in various sport activities (bicycle, running, ski cross country running, swimming) which enables the physician to handle his diabetic patient with an stepwise increasing training program to an optimal training intensity.
Resting echocardiograms were examined in nonathletic healthy young men (controls, n = 16), in highly trained endurance athletes (n = 20), and in endurance athletes who stopped regular training (n = 40). The relative muscular wall thickness (Rel. MWTd), left ventricular internal diameters both in diastole and in systole (LVIDd, LVIDs), thus also the end-diastolic and end-systolic volumes (LVEDV, LVESV), and the stroke volume index (SVI) were greater in the endurance athletes still in training than in the nonathletes. The ejection fraction (EF), heart rate (HR), cardiac index (CI), and mean circumferential shortening velocity (Vcf) were significantly lower in the athletes. During the 60 days of detraining no change was seen in the Rel. MWTd, LVEDV, LVESV, and HR. The SVI became even greater; EF and Vcf rose up to the control level while CI exceeded it. The cardiovascular regulation is therefore assumed to undergo a peculiar shift during detraining in that a persisting cardiac enlargement and bradycardia is associated with a temporarily unstable autonomous control. This imbalance often leads to a hyperkinesis-like syndrome when an athlete stops endurance training abruptly.
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Seven older cyclists (mean age 66.9 years) still engaged in severe endurance training (mean = 8114.3 km year-1) were examined medically, echocardiographically and they underwent a maximal stress test on a bicycle. Mean maximal values were VO2,max = 44.7 ml, Wmax = 261.4 and heart rate = 157.4 beats min-1. The heart volume/max O2-pulse ratio (mean = 46.1) and the TEDD/max O2-pulse ratio (mean = 3.37) were lower compared with age related untrained persons and demonstrate therefore the strong correlation between heart size and function in healthy older aged athletes. Parameters at the anaerobic threshold (lactate concentration 4 mmol l-1) and at the individual anaerobic threshold (lactate concentration 4.08 mmol l-1) showed no significant difference: for heart rate, mean = 133.7; and for W, mean 182.7. The relative oxygen consumption at the anaerobic threshold (mean = 77%/VO2,max) reflect a high endurance capacity of trained old persons, which enables those athletes to outstanding training and competition performance. Derived from that the results show in general the importance of regular endurance training, maintaining an improvement of the cardiovascular system during aging process.
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