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Biomedical subjects

P Haber

Publications and source records attributed to P Haber.

At least 37 records · Page 2Linked to original sources
PubMed1997

Effects of physical training on heart rate variability in diabetic patients with various degrees of cardiovascular autonomic neuropathy.

OBJECTIVE: To investigate the effects of regularly performed endurance training on heart rate variability in diabetic patients with different degrees of cardiovascular autonomic neuropathy (CAN). METHODS: Bicycle ergometer training (12 weeks, 2 x 30 min/week, with 65% of maximal performance) was performed by 22 insulin-requiring diabetic patients (age 49.5 +/- 8.7 years; diabetes duration 18.6 +/- 10.6 years; BMI 25.1 +/- 3.4 kg/m2): i.e., by 8 subjects with no CAN, 8 with early CAN and by 6 patients with definite/severe CAN. A standard battery of cardiovascular reflex tests was used for grading of CAN, a short-term spectral analysis of heart rate variability for follow-up monitoring of training-induced effects. RESULTS: While the training-free interval induced no changes in spectral indices, the 12-week training period increased the cumulative spectral power of the total frequency band (P = 0.04) but to a different extent (P = 0.039) in different degrees of neuropathy. In patients with no CAN the spectral power in the high-frequency (HF) band (0.15-0.50 Hz) increased from 6.2 +/- 0.3 to 6.6 +/- 0.4 In [ms2]; P = 0.016, and in the low-frequency (LF) band (0.06-0.13 Hz) from 7.1 +/- 0.1 to 7.6 +/- 0.3 in [ms2]; P = 0.08 which resulted in an increase of total spectral power (0.06-0.50 Hz) from 7.5 +/- 0.1 to 8.0 +/- 0.3 in [ms2] (P = 0.05). Patients with the early form of CAN showed an increase of spectral power in HF (5.1 +/- 0.2 to 5.8 +/- 0.1 in [ms2], P = 0.05) and LF bands (5.6 +/- 0.1 to 6.3 +/- 0.1 in [ms2], P = 0.008), resulting in an increase of total power from 6.1 +/- 0.1 to 6.6 +/- 0.1 in [ms2] (P = 0.04), whereas those with definite/severe CAN showed no changes after the training period. Training improved fitness in the whole patient cohort. The increased autonomic tone as assessed by spectral indices disappeared after a training withdrawal period of 6 weeks. CONCLUSIONS: In diabetic patients with no or early CAN, regularly performed endurance training increased heart rate variability due to improved sympathetic and parasympathetic supply, whereas in subjects with definite/severe CAN no effect on heart rate variability could be demonstrated after this kind of training.

Autonomic Nervous System Diseases↗
PubMed1996

Pulmonary dysfunction in type 1 diabetes in relation to metabolic long-term control and to incipient diabetic nephropathy.

UNLABELLED: The available data on pulmonary function in type 1 diabetes are still conflicting. Recently, restrictive alterations of pulmonary function were demonstrated in type 1 diabetic patients with end-stage renal failure (diabetic nephropathy), whereas patients with kidney failure from other causes had normal pulmonary function test results. In this study, the prevalence and nature of pulmonary dysfunction in type 1 diabetes and the relationship of pulmonary function tests to incipient diabetic nephropathy and metabolic long-term control were analyzed. Pulmonary function tests were performed in long-standing type 1 diabetic patients (n = 39) with normal serum creatinine levels (< 1.3 mg/dl) and the results compared with those of healthy control (n = 44). The patients were divided into those with a normal urinary albumin excretion rate (AER; n = 21, < 30 mg/day) and those with microalbuminuria (n = 18, AER 30-300 mg/day). We found a significant reduction of the following pulmonary function tests (performed by standardized spirometry and wholebody plethysmography) as compared with controls (C) in diabetic patients with microalbuminuria (M) and in diabetic patients with normoalbuminuria (N): total lung capacity (TLC; % predicted: M 89.6, p < 0.004; N 98.5, p = NS; C 101.1), vital capacity (VC; % predicted: M 83.7, p < 0.001; N 90.2, p < 0.03; C 97.3), forced expiratory volume in 1 s (FEV1; % predicted: M 81.2, p < 0.002; N 88.8, p < 0.02; C 93.8), and diffusing capacity of the lung for CO (DLCO; % predicted: M 83.4, p < 0.04; N 92.4, p = NS; C 95.6). We also found a slight increase of the airway resistance (kPa/l/s: M 0.22, p < 0.03; N 0.2, p = NS; C 0.18). The differences in TLC (% predicted) between diabetic patients with normo- and microalbuminuria were significant (p < 0.04). Further a close relation of pulmonary function tests to metabolic long-term control (mean values of repeated HbA1c measurements) was observed: TLC (% predicted: M r= -0.61, p < 0.007, N p = NS), VC (% predicted: M r = -0.57, p < 0.01; N r= -0.59, p < 0.005), and FEV1 (% predicted: M r = -0.50, p < 0.03; N r= -0.62, p < 0.003). IN CONCLUSION: pulmonary dysfunction in long-standing type 1 diabetic patients is more pronounced in patients with increased AER. Typical features of restrictive pulmonary defects, namely a reduction of TLC (% predicted) plus DLCO (% predicted) were observed predominantly in patients with incipient diabetic nephropathy. The clear correlation of pulmonary function tests with HbA1c measurements stresses the importance of optimal metabolic long-term control in type 1 diabetes.

Adult↗
PubMed1996

[Hemodynamics and ergometric performance modified by low dosage oral contraceptives].

In this pilot study hemodynamic parameters under base-line and performance conditions during a cycle without (N) and with low-dosed oral contraceptives (OC) were of interest. A group of 6 women (age 23.2 +/- 2.1 years) underwent 8 bicycle ergometry sessions each in both a normal cycle and in a cycle on OC. Testing was done in 3 phases of each cycle. Data were obtained on the maximum watt performance, the pulse work capacity at a heart rate of 170 beats per minute (PWC170), as well as on blood pressure and heart rate at rest and at various levels of exercise. No significant differences were found between the N and OC cycles during the follicular phase or in mid-cycle. During the luteal phase, however, faster heart rates and higher blood pressure levels were found for N cycles than in the corresponding phase under OC (p < 0.05).

Adult↗
PubMed1995

Relationship between hepatitis C virus subtypes and clinical features of liver disease seen in alcoholics.

The influence of hepatitis C virus and its subtypes on the clinical course of liver disease in alcoholics was assessed. Hepatitis C virus infection was confirmed by a reverse transcription and polymerase chain reaction method for the hepatitis C virus NS-5 region in the sera of alcoholics with various stages of histologically proven liver disease. The frequency of hepatitis C virus was significantly higher in alcoholics with chronic hepatitis (73%) than in those with liver fibrosis (18%), alcoholic hepatitis (17%), and fatty liver (0%). Hepatitis C virus subtypes, namely K1 and K2, were determined by dot-blot hybridization analysis of the polymerase chain reaction products with specific probes, and their frequencies were 68% and 32%, respectively. The proportion of patients whose serum transaminase levels returned to normal following 4 weeks of abstinence in hospital was significantly lower in alcoholics with hepatitis C virus viremia (glutamic oxaloacetic transaminase: 53.8%; glutamic pyruvic transaminase: 42.3%) than in those without viremia (glutamic oxaloacetic transaminase: 86.2%, p < 0.01; glutamic pyruvic transaminase: 89.7%, p < 0.01). When alcoholics with the K1 and K2 subtypes of hepatitis C virus were compared, normalization of transaminase levels was less frequent in alcoholics with K1 (glutamic oxaloacetic transaminase: 42.8%; glutamic pyruvic transaminase: 28.6%) than in those with K2 (glutamic oxaloacetic transaminase: 88.9%, p < 0.05; glutamic pyruvic transaminase: 77.8%, P < 0.05). These data indicate that hepatitis C virus infection is associated with a reduced rate of recovery of serum transminase levels following abstinence in subjects with alcoholic liver disease, more so in the K1 subtype than in the K2 subtype.

Alcohol Drinking↗
PubMed1995

[Computer-assisted evaluation of bicycle ergometry for determining level of endurance training in physical fitness].

Recent studies have provided evidence of the importance of aerobic endurance training as an independent factor with regard to reducing morbidity and mortality from cardiovascular diseases. Clinical routine shows that test methods and training recommendations are often not specific enough for efficient, yet safe exercise. Software is presented which allows cycle ergometry to be used according to standard criteria in clinical practice, with special attention to the requirements for training with health benefit. Technical requirements: 1. Cycle ergometer with the possibility of increasing exercise intensity by Watt (W) increments; 2. ECG or other device for accurate pulse monitoring; 3. IBM-compatible PC and printer. Based upon the input of data on birth date, sex, height, weight, and heart rate (HR) at rest the programme calculates body surface area, the reference value of physical work capacity of matching subjects and the expected maximal HR (HRmax,exp) and HRmax,exp x 0.95. After the test, input of HR at exhaustion (HRmax), maximum achieved W-increment and time cycled at this intensity in seconds provides various parameters of the individual work capacity. The maximal work performance W (Wmax) is calculated. This value is used to provide further calculations of Wmax.kg-1, VO2max.kg-1 and the maximal work performance as a percentage of the normal value (LF%). The software provides an individual training plan with incremental extension of training time and a prescription for heart rate controlled intensity of endurance training based upon medically accepted training principles. The software enables a standard test to be used and recommends medically efficient and secure quality and quantity guidelines for endurance training.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

[Effects of 4-week ergometry training at an intensity of 30% versus 50% of maximum performance in an inpatient setting].

We investigated the effects of bicycle ergometer training (BET, weekly training time: 120 min, consisting of 8 units of 15 min). In a centre for cardiovascular rehabilitation two groups of 15 patients with coronary heart disease and/or hypertension and/or hyperlipidaemia underwent a four-weeks training period. All patients avoided other training exercises, they all had the same physiotherapy such a massage and the same diet of 800-1200 kcal/day. Current medication was kept constant. The main differences between the groups was the intensity of the training regimes: 30% versus 50% of the individual maximal physical working capacity (PWC), as determined by symptom-limited bicycle ergometry and controlled by an individual training heart rate. The higher intensity of training led to a highly significant increase of 16% in PWC (p < 0.001), whereas the group with the lower training intensity improved by only 5% (p < 0.05). The main effects on body weight (reduction in both groups of about 6%), fat metabolism (significant reduction in cholesterol and low density lipoprotein (LDL) levels in both groups), heart rate and blood pressure (significant decrease in both groups) showed no significant differences between the two groups. In general it can be assumed that the main effects of the 4-week indoor rehabilitation on fat metabolism and blood pressure are due to the diet and weight loss. The 4-week period of endurance training was obviously too short to produce any additional effects. The more intensive aerobic training, which was more effective on PWC, did not reveal better results on fat metabolism, heart rate or blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Pressure↗
PubMed1995

Individual susceptibility to alcoholic pancreatitis: still an enigma.

Evidence is increasing that individuals vary in their susceptibility to alcoholic pancreatitis. Numerous investigators have attempted to account for this individual susceptibility by studying associations between alcoholic pancreatitis and potential risk factors. Those studies, reviewed here, have focused on the amount, type, and pattern of alcohol consumption, genetic markers (such as blood groups, HLA phenotypes, alpha 1-antitrypsin, and alcohol dehydrogenase isoenzyme distribution), diet, hypertriglyceridemia, tobacco consumption, and pancreatic ischemia. Associations between pancreatitis and several of these factors have been reported, but many studies offer conflicting conclusions. A number of studies are difficult to interpret because of methodologic problems, particularly with regard to inadequate controls and small numbers of index subjects. At present, the evidence is insufficient for one to conclude that any of the above-mentioned factors are well-established risk factors for pancreatitis. As a result, individual susceptibility to alcoholic pancreatitis remains unexplained. Clarification of potential risk factors may ultimately lead to the ability to prevent this relatively common disorder, but additional, appropriately designed studies are required.

Alcohol Drinking↗
PubMed1994

Aerobic fitness and sympatho-adrenal response to short-term psycho-emotional stress under field conditions.

A possible relationship between aerobic fitness (AF), measured by maximal cycle ergometry (CE) and sympatho-adrenal response to acute, short lasting psycho-emotional stress was investigated by monitoring heart rate (fc) and excretion of catecholamines. The activation of the sympatho-adrenal system was characterised by the noradrenaline: adrenaline ratio. A group of 11 healthy men [22.8 (SD 2.52) years] lived under identical environmental conditions; their mean maximal oxygen uptake (VO2max) was 47.1 (SD 3.9) ml.min-1.kg-1. After the physiological and psychological laboratory tests had been completed the fc of the subjects was monitored continuously during the "guerilla slide" and "parachute jump by night", two emotionally stressful military tasks. Maximal fc (fc, max) attained during these events was 84.5% and 83% of fc, max during CE (fc, max, CE), respectively. A significant relationship (r = -0.92, P < 0.0002) between fc, max reached during the stressful tasks and VO2max was found only for the guerilla slide, which was preceded by physical strain, sleep deprivation and energy deficit. One subject with some prior experience in parachuting showed the lowest fc response and the lowest sympatho-adrenal activation in both events, independent of the degree of AF. In conclusion, AF was found to influence the sympatho-adrenal and fc response to acute, short-lasting emotional stress when the stressful event was aggravated by preceding physical strain, the magnitude of the stress response depending largely on individual experience and effective mechanisms for coping with specific stimuli.

Adrenal Glands↗
PubMed1993

A rare complication of a central venous catheter system (Port-a-Cath). A case report of a catheter embolization after catheter fracture during power training.

A 36 year old patient received an implantable central venous catheter system for a bone marrow transplantation. One year after the successful transplantation, embolization of the catheter was discovered by a routine x-ray three weeks after beginning of an exercise program with a spring expander including arm exercises. The catheter was removed without further complication via the vena femoralis. We assume that the cause for this incident was material fatigue due to pressure between clavicula and first rib possibly caused by strength training. We suggest as a consequence that patients with an implanted catheter system should before starting exercise consult a sports medicine specialist who would in turn cooperate with the specialist responsible for the catheter, so that an adequate and safe training program can be selected.

Adult↗
PubMed1993

[Amphetamine doping in leisure-time mountain climbing at a medium altitude in the Alps].

Although doping in leisure sports may potentially be of relevance for medical emergency situations, it has attracted much less attention than doping in elite athletes. The aim of our study was to evaluate the prevalence of amphetamine consumption in medium altitude mountaineering. Urine samples were taken from 253 males after a successful ascent. Analysis for amphetamines proved positive for 7.1% of mountaineers climbing above 3300 m. On peaks between 2500 to 3300 meters above sea level, 2.7% of the mountaineers we examined had amphetamines residues in their urine. Below 2500 meters, no positive sample was detected. For tourists living outside of the Alpine range, we noticed a significantly higher proportion of positive analyses. We conclude that attempts to induce a higher performance level by pharmacological means are not overly uncommon in leisure mountaineering. Such a behaviour may be of medical relevance in emergency situations.

Adult↗
PubMed1993

[Effectiveness of relaxation groups in patients with chronic respiratory tract diseases].

In the long-term treatment of patients with chronic respiratory diseases, patient education contributes significantly towards improving the effectiveness of conventional drugs in the treatment of asthma-specific complaints and anxiety, as well as playing a role in improved disease coping. The aim of this study was to verify whether relaxation training programs undertaken subsequent to patient education may have an additional effect with regard to both medical and psychological variables. Relaxation training encompasses the basic exercises of autogenics, as well as exercises of functional relaxation. 49 patients participated in the relaxation group (22 male, 27 female). The mean age was 50.5 +/- 16.5 years. The control group used was made up of 37 patients with chronic respiratory diseases (17 male, 20 female) who had received asthma education, but no further therapeutic intervention. Prior to and immediately after the relaxation training, the following investigations were undertaken: lung function, patient diary, Spielberger anxiety scale, Giessen list of complaints (modified and augmented) and Ziegler coping questionnaire. The linear rating scale model was used for measuring changes. The following significant changes were observed in the relaxation group as compared with the control group: decrease of trait fear, alleviation of asthma-specific complaints and asthma attacks, decrease in sleep disturbances and in morning coughing urge, reduction in the required quantities of controlled-dosage aerosol, and a modified attitude toward the disease in the sense of an improved subjective coping competence.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Psychological↗
PubMed1993

[Systematic strength training in the postmenopause: accompanying densitometric control with DXA].

Of all the forms of osteoporosis, the postmenopausal type is the most important in social medicine due to the potentially high fracture risk in aging. The positive effects of physical activity on bone density have been emphasized in several studies. In this study on 31 female volunteers (minimum age 50 years), who had been postmenopausal for at least 2 years, 16 underwent systematic strength building (training group). They were compared with a control group consisting of 15 female volunteers. The parameters of success were physical strength and bone mineral density (BMD) before and after training. BMD was measured by dual-energy X-ray absorptiometry. The subjects in the control group showed significant decrease in bone density after 6 months: between 6.7 and 22.3% of the values measured at the beginning. The loss was more evident in the proximal femur than in the lumbar spine. In contrast, the subjects in the training group only showed a marginal decrease in bone density in the proximal femur: 0.8 to 3.8% of the earlier values. In the lumbar spine there was even a slight increase (+0.3%) in bone density.

Absorptiometry, Photon↗
PubMed1993

[Therapeutic training and sports in chronic diseases of the lung].

Training is defined as systematic physical activity in order to improve the physical working capacity, which causes measurable morphological and functional changes in organs. Effects and the rules of applying aerobic endurance training in patients with chronic diseases of the lungs are dealt with. Training does not replace the normal medication, but is an additional therapeutic mean in order to regain physical working capacity, lost by chronic immobilization in the natural course of disease. Contraindications are acute diseases and exacerbations, but not a certain degree of the disease. Training does not improve the lung function, but the function of the other organs, the physical working capacity ist based on (circulation, musculature). This helps to use optimally the remaining reserves of lung function. Methods of aerobic endurance training are described, the definition of aims, performance diagnostic and the finding of the exact doses of training according to intensity, duration, frequency and the weekly netto training time. The training in different diseases of the lungs is discussed: In asthma bronchiale the prophylaxis of the exercise induced asthma and permitted and forbidden drugs for asthmatics according to the rules of international olympic committee. In chronic bronchitis with arterial hypoxemia, in restrictive lung diseases and in pulmonary hypertension. At last the way to prescribing training for patients with chronic pulmonary diseases is described as well as the advising of patients wishing to do sport by their own motivation or planning projects, for instance touristic ones, which require physical stress.

Combined Modality Therapy↗
PubMed1993

[The science of medical training].

The medical science of training (MST) is the theoretical basis for a proper advice in problems of physical performance in healthy and people with chronic diseases. This is comparable with the pharmacology as a basis for the advice in internal medicine. The MST deals with the rules, which are valid for improving the physical performance by training, changing the morphology and function of organ systems. Basis of MST is the knowledge of the effects of each training measure and the knowledge of a relation between the doses and the effect of training. Out of 5 basic motoric properties, endurance, strength, coordination, flexibility and fastness, the MST deals with endurance and strength. These 2 basic motoric properties are determined by the morphology and function of organ systems and are changeable by training. Endurance is defined as the faculty of resynthesizing ATP which was consumed by muscular activity. According to the type of resynthesis two aerobic types, extensive aerobic endurance and intensive aerobic endurance, and 2 anaerobic types, lactacide anaerobic endurance and a lactacide anaerobic endurance can be distinguished. These 4 types of endurance are defined biochemically and the methods of training are described, proved and evaluated for use in preventive and therapeutic training. Strength is defined as the faculty of the muscle to produce tension. The methods of training are described, proved physiologically, and evaluated for use in preventive and therapeutic training. General and special rules for sport medical advice for people with enhanced health risk and or chronic diseases are presented.

Humans↗
PubMed1992

Influence of acupuncture on physical performance capacity and haemodynamic parameters.

In a single blind study the question as to whether the needling of specific acupuncture points is able to produce an increase in physical performance capacity and better regulation of heart rate and blood pressure was examined. Thirty-six healthy young men were assigned at random to three groups, receiving either actual acupuncture, placebo acupuncture or no stimulation. Performance was determined by means of a spiro-ergometer test which was carried out at the beginning and at the end of five weeks of treatment consisting of one session per week. The subjects from the group which actually received acupuncture were able to increase maximum performance capacity significantly and also physical performance at the anaerobic threshold. This may be interpreted as a sign of functional improvement in haemodynamic and metabolic mechanisms. There was, on the whole, no noticeable effect produced by the placebo acupuncture. The control group, which received no stimulation, showed unfavourable changes in the values obtained compared with the results of the performance test at the commencement of the study.

Acupuncture Points↗
PubMed1991

Working group recommendations: measuring outcomes of care in geriatric evaluation and management units.

Issues related to measuring outcomes of care in geriatric evaluation and management (GEM) units were identified by the outcomes working group of the GEM evaluation conference. GEM units have as a major goal the improvement or maintenance of both physical and psychosocial function. Suggested outcome measures for physical health included survival, restricted activity days, general health perceptions, comprehensive physical function, and miscellaneous specific types of functioning. In the area of psycho-social function, the working group suggested measuring cognitive function, affect/life satisfaction, social function, and satisfaction with care. The patient's caregiver (eg, spouse or child) is often an important target of GEM care, and the group suggested measuring caregiver burden, life satisfaction, and assessment of patient behavior problems. While the primary goal of GEM units is to improve health status, their effects on the utilization and cost of health care are important to decisions about wide-spread implementation and funding. The group therefore suggested a comprehensive assessment of these outcomes. Among the large array of recommended outcomes, the most important were thought to be mortality, function, and cost.

Activities of Daily Living↗
PubMed1991

[Effect of structured ambulatory training of patients with chronic respiratory tract diseases on the efficiency of long-term care].

In spite of the availability and widespread use of a number of effective medications, the frequency of severe attacks of asthma bronchiale including those with fatal outcome has not decreased. One possible reason for this is the delay in therapeutic intervention of up to 30 minutes resulting either from transport time to a hospital or from the response time of mobile ambulance services. Treatment delays are also frequent co-factors for decreased well-being in non-emergency cases. Prompt initiation of countermeasures, regardless of time or place, can only be guaranteed when the patient himself is capable of carrying them out with the same expertise as his attending physician. Toward this end, a model patient-training program was investigated. The didactic goal of the training was to make the patient an expert in his chronic disease. The medical goal of the training was to improve the quality of a complex long-term therapy and with it, the patient's well-being and quality of life. The content of the training corresponded largely to that contained in a lecture series for medical students or physicians on the same subject. Style and choice of words (avoidance or explanation of medical terminology) was of course adapted to the lay-status of the patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Psychological↗