Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Vigor”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 595 records · Page 33Linked to original sources
PubMed2002

Fatness, physical activity, and television viewing in children during the adiposity rebound period: the Iowa Bone Development Study.

BACKGROUND: Understanding the determinants of adiposity in young children may be particularly critical for preventing adult obesity since the age at which body fatness reaches a postinfancy low point (typically 4-6 years) is inversely associated with obesity later in life. METHODS; We examined cross-sectional associations among fatness, leanness, and physical activity in 467 children (range 4-6 years). Activity was measured using accelerometry and parental report of children's television (TV) viewing. Dual energy X-ray absorptiometry was used to quantify body composition. RESULTS: Minutes spent in vigorous activity and TV viewing were the variables most consistently and most highly associated with adiposity. Children in the lowest quartile for vigorous activity had on average (absolute) body fat percentages that were 4% greater than those children in the highest quartile for vigorous activity. Body fat percentages for children in the highest category for TV viewing were on average 3% greater than those children who watched the least amount of TV. CONCLUSIONS: Low levels of vigorous physical activity and high levels of TV viewing are associated with fatness in young children during the adiposity rebound period. This suggests that increasing children's active play may be important in preventing obesity later in life.

Absorptiometry, Photon↗
PubMed1991

Identification of correlates of physical activity among Latino adults.

127 Latino adults responded to a survey concerning physical activity. Respondents over-represented well educated and middle class Latinos. Subjects reported a mean of 48 minutes/week of walking for exercise. This sample reported less than two episodes per week of vigorous physical activity, again below the recommended 3/wk needed to insure cardiovascular fitness. We expect more representative samples to engage in less physical activity. Stepwise multiple regression analyses were conducted using 24 variables based on Social Learning Theory. A multiple R of 0.66 accounted for over 27% of the variance in walking for exercise (p less than 0.001). Older adults, those with a history of childhood injury, and those who reported friend support were more likely to walk for exercise. Respondents who participated in physical activity during childhood and adolescence (including formal physical education in school) and, paradoxically, those who had models for exercise in childhood were less likely to walk for exercise. A multiple R of 0.75 accounted for 43% of the variance in vigorous physical activity and reached significance (p less than 0.001). Self-efficacy, friends' support, childhood physical activity, and eating a heart healthy diet were positively related to vigorous activity. These results suggest that different correlates influence walking versus vigorous activity, and that correlates of physical activity are different for Latinos compared to Anglos. The findings emphasize the need for larger scale investigations of the determinants of activity within the Latino population.

Attitude to Health↗
PubMed2007

Peripheral bone mineral density and different intensities of physical activity in children 6-8 years old: the Copenhagen School Child Intervention study.

This study aimed to evaluate the association between objectively measured habitual physical activity and calcaneal and forearm bone mineral density (BMD, g/cm(2)), one mechanically more loaded and one less loaded skeletal region, in children aged 6-8 years. BMD was measured in 297 boys and 265 girls by peripheral dual-energy X-ray absorptiometry in the forearm and calcaneus. An accelerometer registered the level of physical activity during 4 days (2 weekdays and the weekend). Weight, height, and skinfold thickness were measured. In order to establish thresholds (count . min(-1)) for bone-stimulating physical activity, we evaluated different definitions of vigorous physical activity. The boys had 3.2% higher distal forearm bone mineral content (BMC, P < 0.001) and 4.5% higher distal forearm BMD (P < 0.001) than the girls. They also carried out 9.7% more daily physical activity and spent 14.6-19.0% more time in vigorous physical activity (all P < 0.05) compared to the girls. In contrast, the girls had 3.8% higher calcaneal BMC (P < 0.01) and 2.5% higher calcaneal BMD (P < 0.05) than the boys. Both calcaneal and forearm BMD were significantly related to total time of daily physical activity as well as with intense physical activity above all the chosen cut-off points (all P < 0.05). The beta value for mean count . min(-1) physical activity was significantly lower than that for all the chosen cut-off points of vigorous activity both for calcaneal and distal forearm BMD. This study suggests that both habitual daily physical activity and amount of vigorous physical activity in children aged 6-8 years are associated with appendicular BMD.

Absorptiometry, Photon↗
PubMed2005

Energy balance and breast cancer risk: a prospective cohort study.

While there is evidence that breast cancer risk is positively associated with body mass index (in postmenopausal women) and energy intake and inversely associated with physical activity, few studies have examined breast cancer risk in association with energy balance, the balance between energy intake and expenditure. Therefore, in the cohort study reported here, we studied the independent and combined associations of vigorous physical activity, energy consumption, and body mass index (BMI), with breast cancer risk. The investigation was conducted in 49,613 Canadian women who were participants in the National Breast Screening Study (NBSS) and who completed self-administered lifestyle and food frequency questionnaires between 1980 and 1985. Linkages to national mortality and cancer databases yielded data on deaths and cancer incidence, with follow-up ending between 1998 and 2000. During a mean 16.4 years of follow-up, we observed 2545 incident breast cancer cases. Due to exclusions for various reasons, the analyses were based on 40,318 subjects amongst whom there were 1673 incident cases of breast cancer. Participation in vigorous physical activity and body mass index were not independently associated with breast cancer risk in the total cohort. A statistically significant positive trend was observed, however, between energy intake and breast cancer risk (P (trend )= 0.01). Although there was some variation in risk associated with vigorous physical activity, and BMI when the analyses were stratified by menopausal status, these interactions were not statistically significant. The interaction between menopausal status and energy intake, however, was of borderline statistical significance (P (interaction )= 0.06), with a statistically significant increased risk of breast cancer associated with highest versus lowest quartile of energy intake among premenopausal women (Hazard Ratio [HR] = 1.45, 95% confidence interval [CI] = 1.13- 1.85, P (trend) = 0.001). There was evidence of an increased risk of breast cancer associated with a relatively high body mass index among postmenopausal women in the highest quartile level of energy intake (Hazard Ratio [HR] = 1.72, 95% confidence interval [CI] = 1.01- 2.93, P (trend) = 0.05). In addition, there was evidence of an increased risk of breast cancer among premenopausal, physically inactive, overweight/obese women who consumed > or =1972 kcal/day compared to physically active normal weight women who consumed <1972 kcal/day (HR = 1.60, 95% CI = 1.08-2.37). Our data suggest that obese premenopausal women with relatively high energy intake may be at increased risk of breast cancer. In addition, energy imbalance, represented by a relatively high energy intake, lack of participation in vigorous physical activity, and a relatively high body mass index, may be associated with increased breast cancer risk, particularly among premenopausal women.

Adult↗
PubMed1989

Effect of rapid mobilization on ejection fractions and ventricular volumes after acute myocardial infarction.

Despite the current practice of early mobilization and early hospital discharge after uncomplicated acute myocardial infarction (AMI), physicians are reluctant to permit normal physical and social activity for several weeks after the AMI "to allow the heart to heal." This study tested whether it was possible to identify a low risk group of patients on day 3 after AMI, and whether vigorous early mobilization from days 4 through 7 affected left ventricular function and volumes (studied by gated blood pool scan on days 4 and 14). There was 1 death in 3 months in 45 patients with uncomplicated AMI suitable for randomization to activity (group A) compared with 11 deaths in 55 patients unsuitable for rapid early mobilization (group B) (p less than 0.01). Early vigorous mobilization in 24 of the group A patients compared with sedentary care in 20 did not affect change in ejection fraction, end-diastolic volume, end systolic-volume, stroke volume, heart rate or cardiac output between days 4 and 14. A very low risk group suitable for early vigorous mobilization can be defined on day 3 after AMI; further, vigorous early mobilization does not affect left ventricular function or volumes. Early return to physical, social and occupational activity after uncomplicated AMI should result in marked reduction in direct and indirect costs of AMI.

Aged↗
PubMed1986

Predictors of adoption and maintenance of physical activity in a community sample.

Predictors of changes in three measures of physical activity over 1 year were examined in a community sample of 1,411 California adults. Five percent of women and 11% of men adopted vigorous activities (e.g., running), and 26% of men and 34% of women adopted regular moderate activity (e.g., walking). About 50% of vigorous exercisers and 25-35% of moderate exercisers dropped out in 1 year. About 9% reported large 1-year increases in globally rated activity level, while about 7% reported decreases in global activity. In multivariate analyses, adoption of vigorous activity was predicted by young age, male gender, and self-efficacy. Maintenance of vigorous activity was predicted by attitudes toward physical activity. Adoption of moderate activity was predicted by health knowledge, and maintenance was predicted by specific exercise knowledge, female gender, and self-efficacy.

Adult↗
PubMed1988

Patterns of physical activity among German adolescents: the Berlin-Bremen Study.

Patterns of leisure-time physical activity among 932 West German boys and girls from two distinct socioeconomic groups were examined longitudinally over a 2-year period beginning with seventh to eighth grade students. Activity indices reflect the weekly time spent in activities, the weekly frequency of participation, and the average duration per activity episode. The indices refer to all activities, to moderate or vigorous activities, or to each individual activity. The average seventh to eighth grade student spent 10.1 hr/week engaged in all of the activities measured. Overall, the time devoted to these activities declined by 10% during the 2-year study period, with the relative decrease being larger for vigorous than for moderate activities. The decline in time spent in vigorous activity was due to a decreased frequency of participation; whereas the decline in moderate activity was primarily attributable to the decreased average duration per episode. Boys spent about 3 hr/week more in all activities than girls, with the difference largely being due to the boys' greater participation in vigorous activities. Weekly activity time among girls did not vary substantially with socioeconomic status. However, compared with boys of higher socioeconomic status, boys in the lower socioeconomic grouping were 2-3 hr/wk more active because they devoted more time to moderate activities. The results indicate that the identified activity patterns in the population strongly depend on the activity dimensions on which the measure focuses.

Adolescent↗
PubMed1988

Adult physical activity behavior: a trend analysis.

One of the health objectives for the nation is to have 60% of adults 18-64 years regularly active in vigorous physical activity by 1990. In this paper an effort is made to determine whether American society is making satisfactory progress toward this goal. Two independent databases are analyzed: time diaries collected from a national sample of American adults in 1981; and the Simmons Market Research Bureau, Inc., survey undertaken in 1984. Participation of adults 25-64 in moderate to vigorous activities that included racquet sports, swimming, hiking, bicycling, skiing, jogging, outdoor gardening, skating, etc. is compared between the two time periods. After adjusting for social desirability bias the results indicated there were a similar number of non-participants of the activities analyzed in 1981 and 1984. There was, however, an increase in the number of adults participating occasionally in vigorous activity, although, there did not appear to be any increase in the number who were regularly active, i.e. at least 3 days/week. Thus, while there are indications that adults 25-64 years are adopting more vigorous activity, less than 20% were regular enough in 1984 for improvements in cardiovascular functioning to occur. Unless there were dramatic increases in the activity status of adults 18-24 years of age which was not assessed in this study, the 1990 goal is unlikely to be met.

Adult↗
PubMed2004

Effects of rofecoxib and naproxen on life expectancy among patients with rheumatoid arthritis: a decision analysis.

BACKGROUND: The VIOXX Gastrointestinal Outcomes Research (VIGOR) trial showed a 53% decrease in the risk of upper gastrointestinal toxicity and a fivefold increase in the risk of myocardial infarction for rofecoxib (a selective cyclooxygenase-2 inhibitor) compared with naproxen. We examined the effects of these competing adverse events on life expectancy in patients with rheumatoid arthritis. METHODS: We used decision analysis to compare the life expectancy of a cohort of rheumatoid arthritis patients taking naproxen versus a similar cohort taking rofecoxib, using data from the VIGOR trial. We incorporated the competing risks of upper gastrointestinal toxicity and myocardial infarction, as well as their long-term health consequences, on the basis of population-based studies. RESULTS: For 58-year-old women with rheumatoid arthritis (i.e., typical of participants in the VIGOR trial), naproxen was associated with a longer life expectancy than was rofecoxib (difference = 4.4 months). This difference was larger among 58-year-old men (7.8 months). The probability that naproxen is associated with a longer life expectancy than rofecoxib among 58-year-old patients was 92% for women and 98% for men. Life expectancy became the same between the two treatments when the risk of upper gastrointestinal toxicity was 70% higher or the risk of myocardial infarction was 40% lower than that of the base case among women, and when the risk of upper gastrointestinal toxicity was 4.4-fold higher or the risk of myocardial infarction was 70% lower among men. CONCLUSION: Our analysis suggests that the competing risks of upper gastrointestinal toxicity and myocardial infarction shown in the VIGOR trial would project a longer life expectancy with naproxen than rofecoxib among patients with rheumatoid arthritis, except in those at low risk of myocardial infarction or at high risk of upper gastrointestinal toxicity.

Aged↗
PubMed2003

Leisure time physical activity and early atherosclerosis: the Los Angeles Atherosclerosis Study.

PURPOSE: Some studies of leisure time physical activity find a cardiovascular benefit for moderate activity, whereas others find benefit only for regular vigorous activity. We examined the relation between physical activity and 3-year progression of carotid atherosclerosis. METHODS: Baseline examinations were conducted during 1995 to 1996 with two follow-up examinations at 1.5-year intervals. Intima-media thickness of the common carotid arteries was determined by B-mode ultrasound in a cohort of 500 randomly sampled women and men, aged 40 to 60 years, who were asymptomatic for cardiovascular disease. Sedentary leisure activity was defined as the lowest quartile of a general activity measure, whereas vigorous activity was defined as aerobic activity > or = 3.5 times per week. The remainder defined the moderate activity group. Analyses were adjusted for confounding variables. RESULTS: The mean (+/- SE) age- and sex-adjusted rates of progression of intima-media thickness declined from 14.3 +/- 1.7 microns per year in sedentary subjects, to 10.2 +/- 1.0 microns per year in moderately active subjects, to 5.5 +/- 1.5 microns per year in vigorously active subjects (P for trend <0.0001), and remained statistically significant after adjustment for other confounding factors (P for trend = 0.0004). Compared with the moderate activity group, the vigorous activity group had lower body mass index and resting heart rate and increased high-density lipoprotein cholesterol level, whereas the sedentary group had an increased resting heart rate. Workplace activity was not protective. CONCLUSION: Physical activity during leisure is inversely related to the progression of atherosclerosis in the carotid artery. This benefit appears to increase throughout the activity continuum.

Adult↗
PubMed1998

New concepts and paradigms in cardiovascular medicine: the noninvasive management of coronary artery disease.

Coronary atherosclerosis is a diffuse heterogeneous process that occurs throughout the length of epicardial coronary arteries. Myocardial infarction and unstable coronary syndromes are caused most commonly by plaque rupture of lipid rich, less severe coronary artery stenoses. Vigorous cholesterol lowering by low fat food and lipid active drugs, control of hypertension, and smoking abstinence stabilize plaque and markedly reduce coronary events and angina pectoris with greater improvement in survival than reported for elective invasive revascularization procedures. The term "regression" or "reversal" of coronary artery disease (CAD) as used clinically incorporates the spectrum of beneficial changes in plaque composition and pathology, modest improvement in anatomic severity, endothelial healing, increased coronary flow and flow capacity, decreased symptoms, and improved survival. Standard coronary arteriography and standard noninvasive diagnostic tests (as commonly used) are inadequate for identifying or assessing severity of diffuse CAD. Newer technology or approaches using noninvasive positron emission tomography (PET), invasive intravascular ultrasound or pressure or flow velocity guide wires provide important new insights into the presence and severity of both segmental and diffuse CAD. Revascularization procedures may be beneficial in selected, restricted circumstances, primarily for 3-vessel disease and reduced left ventricular function and for "hibernating" or "stunned" myocardium. However, the benefits of revascularization procedures on survival in patients with good left ventricular function have not been convincingly documented, with substantive evidence that adverse outcomes outweigh the potential benefits. This collective new knowledge provides the basis for a shift in the management of CAD from an invasive, procedure-oriented viewpoint currently dominant in cardiology toward a noninvasive orientation that views the problem as a graded, continuous, heterogeneously diffuse disease process for which reversal treatment is optimal. Noninvasive management of CAD based on reversal treatment is a valid, safe, effective primary step, but it requires patient and physician knowledge. CAD should be treated immediately at the time of a firm diagnosis by simultaneous, vigorous risk factor management, low fat diet and a statin class drug. For control of high-density lipoprotein and triglycerides, other lipid active drugs should be added or substituted for statins if side effects prevent their use. Low fat food and weight control by appropriate caloric carbohydrate restriction are essential for reducing the highly atherogenic postprandial lipid surge that is not affected by statins. This vigorous reversal treatment, with aggressive anti-anginal and anti-platelet management as needed, should be used in every patient with diagnosed CAD before elective revascularization procedures are considered. In the author's experience, the majority of patients will pursue an effective reversal regimen when it is presented and managed appropriately with strong support by a knowledgeable participating physician providing sustained, intense guidance and pharmacologic control. For the minority of patients not responding to vigorous medical treatment or demonstrating progression, coronary arteriography and revascularization procedures are then appropriate.

Angioplasty, Balloon, Coronary↗
PubMed2003

Physical activity levels of adolescents with congenital heart disease.

Regular physical activity prevents chronic disease and moderate to vigorous participation provides additional health benefits. Therefore, adolescents with congenital heart disease risk developing latent diseases due to real or perceived physical activity restrictions. Habitual physical activity levels, psychological determinants and advice received were examined by postal survey of 434 West Australian adolescents aged 12-18 years with congenital heart disease. Survey results (n = 153) were compared with published normative adolescent data. Total activity was classified as vigorous, adequate or inadequate according to metabolic equivalents, reported frequency and duration. Comparable numbers of respondents and healthy peers were active (winter 62% vs 74%; and summer 73% vs 82% respectively, p = 0.27). However, significantly fewer male respondents were classified as vigorously active compared with healthy peers, in both winter (48% vs 67%, p < 0.02), and summer (48% vs 69%, p = 0.04). Similar, but non-significant, trends were found when comparing female respondents with healthy peers and for mild versus severe disease groups. Self-efficacy ratings did not explain differences in physical activity intensity. Congenital heart disease may impact on the intensity of physical activity undertaken by affected adolescents thus denying additional health benefits. Physiotherapists could facilitate these adolescents to achieve more moderate to vigorous physical activity, to offset adult sedentary behaviour.

Adolescent↗
PubMed1997

Cesarean deliveries: when is a pediatrician necessary?

OBJECTIVE: We evaluated the need for vigorous resuscitation (bag-and-mask ventilation, tracheal intubation, and cardiopulmonary resuscitation) in certain common cesarean deliveries at term to evaluate the need for pediatrician attendance on behalf of the fetus. METHODS: Records of singleton cesarean deliveries (repeat, nonprogressive labor, fetal malposition, fetal heart rate abnormality) at term over 2 years were reviewed for the following: need for vigorous resuscitation, Apgar scores, anesthesia used, and the need for newborn intensive care. The next consecutive, uncomplicated singleton vaginal delivery in each case was used to create a control group. Exclusion criteria included the presence of maternal disease (diabetes, pregnancy-induced hypertension, placenta previa) or suspicion of fetal abnormalities (growth restriction, congenital defect, known meconium staining of the amniotic fluid). There were 834 cesarean deliveries and 834 controls (low-risk vaginal deliveries). RESULTS: Compared with vaginal deliveries, Apgar scores of 6 or less at 1 minute were more frequent in all cesarean deliveries except for the repeat cesarean category. The incidence of needing vigorous resuscitation was as follows: vaginal 1.7%, repeat 3.0%, nonprogressive labor 4.8%, fetal malposition 11.2%, and fetal heart rate abnormality 17.7%. The use of regional anesthesia reduced the need for vigorous resuscitation in cesarean deliveries for the repeat group and the group with nonprogressive labor without fetal heart rate abnormalities to a level similar to that in uncomplicated vaginal deliveries (2.1% repeat; 1.6% nonprogressive labor without fetal heart rate abnormality). CONCLUSIONS: Both repeat cesarean deliveries and cesareans done for nonprogressive labor without signs of fetal heart rate abnormality, when performed under regional anesthesia, may not need a pediatrician in attendance because of minimal fetal risk.

Adult↗
PubMed1999

The effects of pyruvate supplementation on body composition in overweight individuals.

A 6-wk, double-blinded, placebo-controlled study was done to ascertain the effects of pyruvate supplementation (6 g/d) on body weight, body composition, and vigor and fatigue levels in healthy overweight Caucasian men and women. Twenty-six individuals were randomly assigned to a placebo group (seven men, seven women) and a pyruvate-supplemented group (three men, nine women). In addition, all subjects participated in a 3 d/wk exercise program, which consisted of a 45-60 min aerobic/anaerobic routine. After 6 wk of treatment, there was a statistically significant decrease in body weight (-1.2 kg, P<0.001), body fat (-2.5 kg, P<0.001), and percent body fat (23.0% pre versus 20.3% 6 wk post) in the pyruvate group. Furthermore, Profile of Mood States fatigue and vigor scores improved significantly for the pyruvate group (P<0.05) at 6 wk (vigor) and 4 and 6 wk (fatigue). There was no significant change in total lean body mass in the pyruvate group. The placebo group demonstrated a significant increase (P<0.05) for POMS vigor at 2 and 4 wk with no changes occurring in any of the remaining parameters measured. Thus, the ingestion of 6 g of pyruvate for 6 wk, in conjunction with mild physical activity, resulted in a significant decrease in body weight and fat mass.

Adult↗
PubMed2000

Physical activity surveillance in the 21(st) century.

PURPOSE: The 1996 Surgeon General's Report on Physical Activity and Health emphasized the health-related benefits of moderate-intensity physical activities, especially everyday activities. Unfortunately most surveillance systems in the U.S. primarily measure sports-related activities, particularly vigorous intensity sports. This report describes a new physical activity surveillance instrument designed to go beyond our current measures and include moderate-intensity everyday activities.METHODS: Data were collected from a nationally representative sample of adults (n = 5010). Questions were asked about occupational activity (mostly sitting; mostly walking; mostly heavy labor); walking (for exercise, transportation, or any other reason); moderate-intensity activities (brisk walking, yard work, vacuuming); vigorous-intensity activities (running, aerobics, heavy yard work); and strengthening activities (lifting weights, pull-ups, sit-ups). Questions included frequency and duration of activities. Respondents were defined as recommended if they participated in either moderate-intensity activities >/=30 min/day for >/=5 days/wk OR vigorous-intensity activities >/=20 min/day for >/=3 days/wk. Insufficient was defined as not meeting recommended levels while inactive was defined as no leisure-time activity.RESULTS: Overall 40% of adults were in the recommended group, 44% were in the insufficient group and 16% were inactive. Among working adults 37% had jobs that involved mostly walking or heavy labor and about 50% of those also were in the recommended group. Among the 63% of working adults who report mostly sitting at work, 39% were in the recommended group.CONCLUSIONS: These results suggest that measuring only leisure-time physical activity may under represent the physical activity experience of many U.S. adults. Broadening the concept of physical activity beyond traditional sports-related vigorous "exercise" may provide a more accurate picture of the prevalence of health-related physical activity.

Journal Article↗
PubMed1997

Physical activity, functional limitations, and the risk of fall-related fractures in community-dwelling elderly.

This case-control study examines the association of vigorous and mild physical activity with fall-related fractures in a community-dwelling population age 65 and older in South Florida. Vigorous physical activity was defined as exercising, doing heavy housecleaning, or other hard labor three or more times per week in the month prior to the index date; mild physical activity was defined as the number of hours per day subjects reported spending on their feet. A case was any subject who sustained a fall-related fracture (ICD-9CM-800 through ICD-9CM-829) over a 21-month period (n = 471). Controls were at 10% random sample selected from the Health Care Financing Administration Medicare files (n = 712). The presence of any limitation in activities of daily living (ADL) significantly modified the effect of vigorous physical activity. Physically active subjects with no limitations (ADL = 0) were less likely to sustain a fall-related fracture than were inactive subjects with an adjusted odds ratio (aOR) of 0.6, (0.5-0.8 95% CI), and active subjects with any limitation (ADL > or = 1) had an aOR of 3.2 (1.1-9.8 95% CI). Limiting this analysis to 159 hip fracture cases produced similar results. Mild physical activity was not associated with fracture. These results suggest that vigorous physical activity is associated with a lower fracture risk among elderly persons who have no limitation in ADL and with a higher risk among those with any limitations.

Accidental Falls↗
PubMedDate not supplied

Achalasia and chest pain: effect of laparoscopic Heller myotomy.

Some patients with achalasia complain of chest pain in addition to dysphagia and regurgitation. Chest pain is said to be most common in young patients who have been symptomatic for a short time, and who often have vigorous achalasia (distal esophageal amplitude >/=37 mm Hg). Although pneumatic dilatation is reported to improve chest pain in 20% of patients, the effect of laparoscopic Heller myotomy on chest pain is unknown. The aim of this study was to determine the following in achalasia: (1) the prevalence of chest pain; (2) the clinical and manometric profiles of patients with chest pain; and (3) the effect of laparoscopic Heller myotomy. Between 1990 and 2001, a total of 211 patients with achalasia were studied (upper gastrointestinal series, esophagoduodenoscopy, and manometry). A total of 117 patients (55%) had chest pain in addition to dysphagia and regurgitation; 63 (54%) of these 117 patients underwent laparoscopic Heller myotomy and Dor fundoplication. Median follow up was 24 months. Age (49+/-16 years vs. 51+/-14 years [mean+/-SD]), duration of symptoms (71+/-91 months vs. 67+/-92 months [mean+/-SD]), and presence of vigorous achalasia (50% vs. 47%) were similar in those with and without chest pain. Ten (16%) of the 63 patients with chest pain who underwent Heller myotomy had vigorous achalasia. Postoperatively chest pain resolved in 84% and improved in 11% of patients. There was no difference in clinical outcome between patients with and without vigorous achalasia. These data demonstrate the following: (1) chest pain was present in 55% of patients with esophageal achalasia; (2) chest pain was not related to age, duration of symptoms, or manometric findings; and (3) laparoscopic Heller myotomy improved chest pain in 95% of patients, regardless of the manometric findings. Thus laparoscopic Heller myotomy was highly effective in treating achalasia with chest pain.

Chest Pain↗
PubMed2002

Physical activity and the metabolic syndrome in a tri-ethnic sample of women.

OBJECTIVE: To determine the association of moderate-intensity physical activity (PA), vigorous-intensity PA, and maximal treadmill duration with the metabolic syndrome among African-American (n = 49), Native-American (n = 46), and white (n = 51) women (ages, 40 to 83 years), enrolled in the Cross-Cultural Activity Participation Study. RESEARCH METHODS AND PROCEDURES: The metabolic syndrome was defined as three or more of the following risk factors: waist circumference >88 cm, blood pressure > or =130/85 mm Hg, fasting glucose > or =110 mg/dL, hypertriglyceridemia (> or =150 mg/dL), and high-density lipoprotein-cholesterol <50 mg/dL. PA was determined from detailed PA records that included all PA performed during two consecutive 4-day periods. Maximal treadmill duration was determined from a graded exercise test. Women were categorized into quartiles of moderate-intensity PA, vigorous-intensity PA, and maximal treadmill duration. Multiple logistic regression was used to estimate odds ratios of the metabolic syndrome as a function of the four PA categories, adjusted for age, ethnicity, study site, menopausal status, and use of hormone-replacement therapy. RESULTS: The adjusted odds ratio for the metabolic syndrome was 0.18 (95% confidence interval, 0.33 to 0.90) for women in the highest category of moderate-intensity PA compared with women in the lowest category (p = 0.01 for trend). Similar associations were observed for the metabolic syndrome with vigorous-intensity PA (p = 0.01 for trend) and maximal treadmill duration (p = 0.0004 for trend). DISCUSSION: Higher levels of moderate and vigorous-intensity PA and greater maximal treadmill duration were inversely associated with the metabolic syndrome among an ethnically diverse sample of women.

Adult↗