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At least 757 records · Page 42Linked to original sources
PubMed1976

The aetiology of non-exertional angina pectoris.

The occurrence of angina pectoris while at rest, although long recognized, has not been satisfactorily explained. In the non-exertional attacks studied there was an increase in heart load, as estimated by the product of heart rate and systolic pressure. Angina occurred when the load exceeded a critical level. Recumbency was associated with 94% of non-exertional attacks; 58% followed a meal; in 54% both factors were present. It is suggested that recumbency causes an increase in heart load because of expansion of blood volume by transfer of fluid from interstitial spaces, and that a meal does so because of digestive activity.

Aged↗
PubMed2006

Minimally invasive fasciotomy in chronic exertional compartment syndrome and fascial hernias of the anterior lower leg: short- and long-term results.

This study evaluated the efficacy of a minimally invasive percutaneous fasciotomy in chronic exertional compartment syndrome and fascial hernias of the anterior lower leg (N = 118). Approximately one-third of symptomatic legs (n = 41) demonstrated fascial herniation and underwent fasciotomy without compartment pressure measurements via a small percutaneous incision using a fasciotome. Symptomatic legs with an intact fascia (n = 77) received similar operative treatment based on pressure measurements. Relief of symptoms was obtained in all but two patients. Postoperative complications included hematoma (9%), superficial peroneal nerve injury (2%), anterior ankle pain (5%), and recurrence (2%). Most patients (96%) reported unlimited exercise after a mean follow-up of 62 months. However, mild symptoms associated with nerve injury as well as ankle pain persisted (4%). A minimally invasive fasciotomy of the anterior lower leg harboring fascial hernias or a chronic exertional compartment syndrome is effective. Complications such as nerve injury and anterior ankle pain may be related to a too distally performed fasciotomy.

Administration, Cutaneous↗
PubMed2000

Nitric oxide redox species exert differential permeability effects on the blood-brain barrier.

Excessive production of nitric oxide (NO) in the central nervous system is suspected to contribute to neurodegenerative diseases. Previous studies showed that excessive central nervous system NO increased the permeability of the blood-brain barrier (BBB) during experimental meningitis. The present work hypothesizes that the various NO redox forms (NO(*), NO(+), NO(-)) differentially mediate disruption of the BBB. Pharmacological agents that release NO redox forms (i.e., NO prodrugs) were selected based on the rate of NO release and the liberated NO redox form. An in situ rodent brain perfusion preparation was used to administer NO prodrugs into the cerebrovascular circulation, followed by brain perfusion with [(14)C]sucrose, a marker of BBB integrity. Cerebrovasculature infusion of certain NO prodrugs caused a significant, 2- to 5-fold BBB permeability increase in all forebrain regions (P <.01). The NO prodrug rank order of BBB disruption was S-nitroso-N-acetylpenicillamine-beta-cyclodextrin (releases NO(*), NO(+), and NO(-)) > Angeli's salt (NO(*), NO(-)) > MAHMA NONOate approximately diethylamine NONOate (NO(*)) > spermine NONOate (NO(*)) > DETA NONOate approximately Piloty's acid (negligible NO redox release) approximately saline. When normalized to BBB disruption caused by hyperosmotic mannitol (100%), S-nitroso-N-acetylpenicillamine-beta-cyclodextrin (NO(*), NO(+), and NO(-)) elicited approximately 45% disruption, Angeli's salt (NO(*), NO(-)) elicited approximately 18% disruption, and the NONOates (NO(*)) ranged from approximately 0 to 8% disruption. Cerebral blood flows and intracranial pressures were within normal limits for each tested NO prodrug, thereby suggesting that BBB disruption was not secondary to altered cerebral perfusion. Collectively, the results of this work identify that NO(*) alone exerts modest BBB disruption compared with the specie combination of NO(*) and NO(-), and the greatest disruption is exerted by the combination of NO(*), NO(-), and NO(+).

Animals↗
PubMed2001

Diagnosing exertional rhabdomyolysis: a brief review and report of two cases.

Exertional rhabdomyolysis is a potentially dangerous condition that involves release of intracellular contents from skeletal muscle in concentrations that may cause renal or other systemic complications. The purpose of the two case reports presented is to assist clinicians in recognizing this condition and in considering its predisposing factors. This paper describes two patients who, in the presence of several predisposing risk factors, developed exertional rhabdomyolysis. After diagnoses of rhabdomyolysis were reached, both patients were admitted to a local hospital for several days of monitoring and treatment. After 1 to 2 months of activity modification, both patients successfully resumed full physical activity and military duty.

Adolescent↗
PubMed2001

Death due to microvascular occlusion in sickle-cell trait following physical exertion.

The heterozygous condition characterized by the presence of hemoglobin AS (sickle-cell trait) occurs in approximately 8% of the American black population. Unlike the homozygous state (sickle-cell disease), sickle-cell trait is not widely recognized as a cause of life-threatening illness or death despite over 30 case reports describing fatal or serious complications of exercise in young black males with this condition. These reports identify heat stress, dehydration, viral illness, and poor physical conditioning as factors which may contribute to exertional rhabdomyolysis and sudden death, suggesting multifactorial etiology. However, since sickling is known to occur postmortem, it remains controversial as to whether the pathogenesis of these exercise related deaths involves microvascular obstruction by sickled erythrocytes. We describe three young black individuals with no significant past medical history who died following physical exertion. In all three cases, postmortem hemoglobin electrophoresis demonstrated hemoglobin AS. In none of the cases was the body temperature found to be elevated. These cases serve to remind the forensic community that, in the proper setting, sickle-cell trait must be viewed as a potentially fatal disorder.

Adult↗
PubMed1992

[Poor tolerance of exertion during sports and bronchial hyperreactivity].

135 sportsmen and women, 55 girls, 80 boys, aged from 7 to 30 years, from various sports, who complained of bad tolerance of exertion were examined with an exercise test and isocapnic spontaneous hyperventilation. 61, about 45%, during a hyperventilation test had a fall of V.E.M.S. greater than or equal to 20%, showing bronchial hyperreactivity. After three tests, this fall index was greater than or equal to 50%. 68% of the positive responses were seen in boys and 2/3 of the subjects with a positive response were atopics. No other argument could be maintained from the questioning or clinical history to predict the positive or negative character of the hyperventilation (age, sporting level, symptoms, previous asthma or asthmatic, allergy). H.S.V.I. of the chests of a sporting population that complains of exertion intolerance, therefore allows verification of an H.R.B. assessment of its severity and to follow evolution after treatment.

Adolescent↗
PubMed2003

Dyspnea on exertion, fatigue, and pallor in a 50-year-old active duty soldier.

OBJECTIVE: To discuss a comprehensive diagnostic approach to an active duty patient presenting with dyspnea on exertion, fatigue, and pallor. A 50-year-old active duty E-6 white male in Al Udeid, Qatar, presented with progressive dyspnea on exertion, fatigue, and new pallor. This case illustrates the course of events from Al Udeid to the Walter Reed Army Medical Center, where the final diagnosis was made. Along the way, questions with discussions explore the various diagnostic and management aspects of his case and highlight military relevant issues that include efficient diagnostic algorithms in the field and transfusion of scarce blood products.

Algorithms↗
PubMed1992

Endogenous tumor necrosis factor exerts its protective function intracellularly against the cytotoxicity of exogenous tumor necrosis factor.

Based on the findings that expression of endogenous tumor necrosis factor (enTNF), which is not present in TNF-susceptible cells, was generally observed in TNF-resistant cells and that TNF gene transfection gives rise to TNF resistance, the assumption was made that enTNF may be a protective protein against the cytotoxicity of exogenous TNF. However, it remains unknown whether the protection by enTNF is exerted in an intracellular or extracellular (autocrine) manner. We therefore transfected a nonsecretory human TNF gene (pTNF delta pro) into highly TNF-sensitive mouse tumorigenic fibroblasts (L-M cells) and investigated their TNF susceptibility. The transfectants expressed enTNF which was not secreted into the medium and acquired an appreciable degree of resistance to exogenous TNF. A significant increase in the manganous superoxide dismutase level was also noted in the transfectants. These findings suggest that enTNF exerts its protective function intracellularly by inducing manganous superoxide dismutase production.

Animals↗
PubMed2004

[Sports requiring stressful physical exertion cause abnormalities in plasma lipid profile].

OBJECTIVES: To study the effect of different types of sports on plasma lipid profile. Subjects and method. Fasting plasma levels of total, LDL- and HDL-cholesterol (TC, LDLc, HDLc), triglycerides, phospholipids, apo A-I, apo B-100, and Lp(a) were measured in 28 swimmers, 17 volleyball players and 23 soccer players, and in a control group. All subjects participated in official national competitions except the control group. The results were compared to those in a control group of 26 healthy sedentary subjects. All groups were matched according to age, body mass index and nutritional status. Cutoff points to classify subjects with high plasma concentrations of Lp(a) and LDLc were 32 mg/dL and 128 mg/dL, respectively. For other variables the cutoff points were the third quartile values recorded in the control group, except for apo A-I and HDLc, for which we used the first quartile values. RESULTS: Persons who practice sports involving a high level of physical exertion (volleyball and soccer players) had a less favorable lipid profile compared to control subjects. In contrast, swimmers had a more favorable lipid profile. The odds ratio for lipid profile anomalies was significantly higher in volleyball and soccer players, and lower in swimmers. In the former two groups we observed a clear tendency toward simultaneous elevations in LDLc, apo B-100 and Lp(a). In contrast, the opposite interaction was seen in swimmers, who had lower values for all lipids. CONCLUSION: Our results show that stressful physical exertion can lead to abnormalities in plasma lipid profile.

Adult↗
PubMedDate not supplied

[Characterisation of the influence exerted by the visual factor in patients with balance disorders].

INTRODUCTION: Visual information provides data about the position and movement of the head with respect to objects and serves as a source of reference for the proper perception of verticality. It also plays a specific role in postural control by modifying the efficiency of the vestibular and proprioceptive responses. AIMS: Our aim was to determine how visual information interacts with the symptoms of patients with vertigo, dizziness or instability and to find out the degree of disability it produces. PATIENTS AND METHODS: A study was conducted in 200 patients who had visited because of dizziness, vertigo, instability or loss of balance. We analysed the aspects related to the clinical symptoms of the patients. First, we examined the influence visual stimuli have on the symptoms of vestibular disease itself and their repercussions on the situation between crises. Second, the degree of disability was evaluated on the specific DHI (Dizziness Handicap Inventory) questionnaire. RESULTS: As regards the influence exerted by visual stimulation on the main symptoms, 77.5% reported that it had no effect and 21% said that it made them worse. With regard to the influence of visual stimulation during the intercritical period, it was of no relevance in 53.5% of patients, 26.5% were unaffected, it had an exacerbating effect in 4% and in 7.5% it induced it. Different disorders were observed depending on the type of disease suffered by the patient, and disability was greater according to the influence exerted by the visual factor. CONCLUSIONS: Postural adjustments induced by visual stimuli are capable of triggering instability with serious consequences.

Disability Evaluation↗
PubMed2005

Bacillus clausii exerts immuno-modulatory activity in allergic subjects: a pilot study.

UNLABELLED: Bacillus clausii has been demonstrated to exert some immunomodulatory activities and to be safe. Allergic subjetcs show Th2 polarization and defect of T regulatory cells. Aim of the study was to investigate whether Bacillus clausii administration in allergic subjects might modulate cytokine pattern. Ten subjects (mean age 22.3 years) suffering from allergic rhinitis were enrolled. Bacillus clausii spores (Enterogermina: 2 billions spores/vial) were administered at the dosage schedule of 3 vials a day for 4 weeks. Nasal lavage was performed in all subjects before and after the treatment. A panel of cytokines, including IL4, IL10, IFNgamma, and TGFbeta, was measured by immunoassay in the fluid recovered from nasal lavage, before and after the treatment. RESULTS: Bacillus clausii treatment showed a significant decrease of IL4 levels (p=0.004) and a significant increase of IFNgamma (p=0.038), TGFbeta (p=0.039), and IL10 (p=0.009) levels. In conclusion, this study shows that the Bacillus clausii may exert immuno-modulating activity by affecting cytokine pattern in allergic subjects and confirms previous study conducted in allergic children.

Adolescent↗
PubMed2005

Chronic exertional compartment syndrome: diagnosis and management.

During exercise, muscular expansion and swelling occur. Chronic exertional compartment syndrome represents abnormally increased compartment pressures and pain in the involved extremity secondary to a noncompliant musculofascial compartment. Most commonly, it occurs in the lower leg, but has been reported in the thigh, foot, upper extremity, and erector spinae musculature. The diagnosis is obtained through a careful history and physical exam, reproduction of symptoms with exertion, and pre- and post-exercise muscle tissue compartment pressure recordings. It has been postulated that increased compartment pressures lead to transient ischemia and pain in the involved extremity. However; this is not universally accepted. Other than complete cessation of causative activities, nonoperative management of CECS is usually unsuccessful. Surgical release of the involved compartments is recommended for patients who wish to continue to exercise.

Chronic Disease↗
PubMed2005

Tumor-immune memory T cells from the bone marrow exert GvL without GvH reactivity in advanced metastasized cancer.

The bone marrow has been shown to represent a unique microenvironment where T cell immune responses against tumor associated antigens can be initiated and tumor-immune memory T cells are enriched. In the present study the graft versus leukemia (GvL) reactivity of bone marrow derived tumor-immune memory T cells was analyzed in an allogeneic minor histocompatibility different murine GvL tumor model with late stage disease. A single adoptive cell transfer of B10.D2 donor immune bone marrow cells (iBM) into sub-lethally irradiated late stage ESb-MP tumor-bearing DBA/2 mice led to a complete tumor remission and to significant life prolongation. Even though the frequency of bone marrow resident T cells is only around 2%, the GvL reactivity of iBM was superior to immune cells from the spleen (iSPL) or to those from the peritoneal cavity (iPEC) of the same immunized donors. iPEC exerted mostly unwanted graft versus host (GvH) reactivity, while iSPL exerted GvL and GvH reactivity. Bone marrow cells from naive donor mice or T cell depleted iBM cells were completely devoid of GvL reactivity. The low number of tumor-immune memory T cells thus conferred the GvL reactivity of iBM cells.

Animals↗
PubMed2006

Acute exertional compartment syndrome of the superficial posterior compartment of the leg.

Acute exertional compartment syndrome of the superficial posterior compartment of the leg secondary to minor soft tissue injury is rare. This case series highlights the risk of misdiagnosis as deep venous thrombosis, followed by inadvertent anticoagulation. The delay in management did fortunately not lead to catastrophic consequences. Clinicians must not dismiss the possibility of an acute exertional compartment syndrome in the absence of direct trauma or after minor closed soft tissue injury.

Acute Disease↗
PubMed1992

Decreased perfusion in myocardial region of normal donor artery secondary to collateral development. Stress 201Tl myocardial emission CT performed in patients with single vessel exertional angina having collaterals.

Thirty-one patients suffering from single vessel exertional angina with collaterals (Group A) were evaluated by stress 201T1 myocardial emission CT (Tl-SPECT) with 16 controls of severely stenotic single vessel exertional angina without collaterals (Group B). Group A included 21 patients (68%) who showed an extensive perfusion defect in double artery myocardial regions, including the normal donor artery myocardial region (DMR). However, there were no such cases in Group B, giving a significant difference between these 2 groups (p less than 0.001). Four patients in Group A, having a perfusion defect both in DMR and in the collateral dependent myocardial region (CMR) underwent a successful percutaneous transluminal coronary angioplasty (PTCA) with disappearance of collaterals. Tl-SPECT findings after PTCA showed no perfusion defect either in CMR or in DMR. This has been explained on the basis that the coronary collaterals stole blood and produced perfusion defect in DMR.

Aged↗
PubMed1991

Exertional muscle injuries: magnetic resonance imaging evaluation.

Exertion-related muscle pain is frequent in athletes and patients alike; however, its severity and significance may be difficult to assess clinically. MRI can be used to evaluate myalgia, strains, delayed-onset muscle soreness, chronic muscle overuse syndromes, muscle contracture, and sequellae of muscle injuries such as myositis ossificans and compartment syndrome. MRI documents the distribution of affected muscles, the presence of focal hematoma, fascial herniation, and subsequent healing, fibrosis, or fatty infiltration. MRI is useful in evaluating acute and delayed exertional muscle injuries.

Athletic Injuries↗
PubMed1990

[Combined therapy with propranolol and diltiazem in chronic exertional angina].

The effects of diltiazem, 240 mg/day, were studied in 12 patients with chronic exertional angina and angiographically proven coronary artery disease, who received maintenance therapy with propranolol. Mean age was 60.1 years (range 46 to 67). Patients received propranolol, 60 to 240 mg/day, before and during the study. A double blind, placebo controlled, cross-over design was used to test the effect of added diltiazem, during 8 weeks. Duration of exercise varied from 398 +/- 30 (mean +/- SEM) to 419 +/- 37 (placebo) or 469 +/- 35 sec (diltiazem) (NS). Time to appearance of angina varied from 283 +/- 32 to 313 +/- 34 and 302 +/- 27 sec, respectively (NS). Resting and maximal effort heart rate and blood pressure did not differ among basal, placebo and diltiazem conditions. Segmental wall motion analysis by radioisotopic ventriculogram revealed dyskinetic zones during placebo or diltiazem therapy. Basal ejection fraction did not increase during exercise and this was not modified by diltiazem or placebo. Thus, the addition of diltiazem to propranolol in patients with chronic, exertional angina failed to modify angina threshold, exercise duration or left ventricular performance.

Aged↗
PubMed1979

Cellular antiproliferative action exerted by auranofin.

Auranofin (AF) is a new orally absorbed coordinated gold compound currently undergoing Phase I studies for its use in the treatment of rheumatoid arthritis. Our investigations with RAJI lymphoma, HeLa carcinoma, and EBV-transformed cells indicate AF exerts an inhibitory effect on DNA, RNA, and protein synthesis as assessed by 3H-thymidine, 3H-uridine, and 3H-leucine uptake, respectively. A rapid and persistent dose dependent inhibition of 3H-thymidine uptake was observed at gold concentrations of 50-100 microgram/dl while all parameters were inhibited after a 24 hr exposure to 100 microgram/dl. Reductions in viability and surface morphological changes were also observed. These results suggest AF exerts a significant inhibitory effect on essential biological processes and functions.

Aurothioglucose↗