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Influence of exercise and life-style variables upon high density lipoprotein cholesterol after myocardial infarction.

Two groups of postcoronary patients (n = 35 and n = 27) were followed for 1 year. Group 1, recruited 2 to 3 months after infarction, showed a 9% gain of maximum oxygen intake in response to an average of 878 km of walking at speeds increasing to 6.9 km.hr-1. High density lipoprotein (HDL) cholesterol showed a statistically significant, but small, increase over the period of training. If expressed as a ratio to either low density lipoprotein or total cholesterol, the change was correlated with decreases of cigarette consumption, alcohol intake, and body mass, but was unrelated to speed or training distance. Group 2 patients trained an average of 50 to 80 km a week. In this group, HDL cholesterol correlated well with the weekly running distance, declining in those subjects who detrained, and increasing in those who intensified their training. We conclude that the dose of exercise necessary for inducing any substantial increase of HDL cholesterol is about 20 km.wk-1.

Alcohol Drinking↗

Oxygen consumption and hemodynamic response of exercises used in training of patients with recent myocardial infarction.

We investigated oxygen consumption (ml/kg/min) and hemodynamic response (peak heart rate-systolic blood pressure product) to individual exercise activities before and after exercise training in 22 male postmyocardial infarction patients (PMIP). Activities included swimming, walk/jogging, volleyball, calisthenics and exercise dance routines. Oxygen consumption was determined immediately after exercise by the Douglas bag gas collection procedure and, in selected patients, by a Max Planck respirometer during exercise. Hemodynamic data were obtained by pulse count and cuff sphygmomanometer. The increase in oxygen consumption and the decrease in rate-pressure product after each activity were significant (p less than or equal to 0.01). There were no differences in oxygen consumption between the Max Planck respirometer technique and collection (Douglas bag method) immediately after exercise. The oxygen consumption obtained for PMIP compared with available cumulative data on normal subjects is significantly variable, suggesting the need for caution when prescribing exercise for the PMIP based on energy costs of standard exercise measurements in normals. This was particularly relevant because of the significantly high oxygen consumption incurred during swimming.

Body Weight↗

Cardiorespiratory responses to exercise training after orthotopic cardiac transplantation.

We have tested the feasibility and effectiveness of a 2 year (average 16 +/- 7 months) walk/jog exercise program on 36 male orthotopic cardiac transplant patients (21 to 57 years old) seen initially 2 to 23 months after surgery. Comparison of initial exercise test results with those in 45 age-matched normal men showed the patients to have a lesser lean body mass (56 +/- 7 vs 63 +/- 8 kg, p less than .001), with a higher resting heart rate (104 +/- 12 vs 77 +/- 14 beats/min, p less than .001) and systolic (138 +/- 16 vs 129 +/- 17 mm Hg, p less than .001) and diastolic (95 +/- 14 vs 84 +/- 10 mm Hg, p less than .001) blood pressures. Peak power output was less than normal (101 +/- 27 vs 219 +/- 41 W, p less than .001), as was peak heart rate (136 +/- 15 vs 176 +/- 13 beats/min, p less than .001), peak oxygen intake (VO2max) (22 +/- 5 vs 34 +/- 6 ml.kg.min-1, p less than .001), and absolute anaerobic threshold (1.18 +/- 0.40 vs 2.04 +/- 0.40 liters.min-1, p less than .001). Peak ventilatory equivalent was higher (48 +/- 9 vs 37 +/- 61.1-1, p less than .001). Cardiac output (Q), as estimated by the CO2 rebreathing method, was slightly above normal at rest (p less than .01), but below normal at two submaximal work rates. The group's average weekly training distance was 24 km, with eight highly compliant patients progressing to 32 km or more weekly. After training, lean tissue increased (+2.4 +/- 3.1 kg, p less than .001), and resting values were reduced for heart rate (-4 +/- 11 beats/min, p less than .05), systolic (-13 +/- 20 mm Hg, p less than .001), and diastolic (-9 +/- 17 mm Hg, p less than .001) blood pressures. There were significant reductions in submaximal values for minute ventilation (VE), ratings of perceived exertion, and diastolic blood pressure at equivalent workloads. Peak values increased for power output (+49 +/- 34 W, p less than .001), VO2max (+4.0 +/- 6.0 ml.kg.min-1, p less than .001), VE (+20 +/- 20 l.min-1, p less than .001), and heart rate (+13 +/- 17 beats/min, p less than .001), and decreased for diastolic blood pressure (-8 +/- 15 mm Hg, p less than .001).(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

Biocompatibility assessment of polytetrafluoroethylene/wollastonite composites using endothelial cells and macrophages.

The aim of the study was to prepare a composite of polytetrafluoroethylene/wollastonite (PTFE/W) and evaluate its biocompatibility with endothelial cells. A composite of PTFE with wollastonite in the proportion 90/10 w/w was prepared. The dynamic storage modulus of composite is found to increase from 260 to about 453 MPa at room temperature while a marginal increase is observed in the compressive modulus. Higher values of storage modulus of PTFE/W relative to pristine PTFE over a range of temperature indicated the contribution of wollastonite in improving the rigidity of PTFE. Electron microscopic visualization of composite surface indicates suitable morphology for cell growth with the cross-section showing no evidence of bonding between PTFE and wollastonite. The water contact angle of the composite indicates increased hydrophilicity over native PTFE due to the presence of wollastonite. A direct-contact test did not show any deleterious effects on endothelial cell morphology and viability, indicating its compatibility. Leached-out products (LOP) from the composite were determined to be non-toxic as tested by tetrazolium (MTT) and Neutral red uptake (NRU) assays. Mouse peritoneal macrophages cultured in the presence of the composites did not show upregulation of activation markers such as CD11b/CD 18 (Mac-1), CD45, CD 14, and CD86 (B7.2) in comparison to macrophages cultured in contact with PTFE alone, indicating its non-activating nature. LOP did not induce proliferation of mouse splenic lymphocytes suggesting its immuno-tolerance. In static incubation assay contact with composite did not lead to hemolysis thus exhibiting preliminary hemocompatibility of the material. Suitable physico-chemical properties and well tolerance by endothelial cells and macrophages make this composite a prospective biomaterial. One could foresee the applications of this composite in areas where materials need to possess high rigidity and are subject to elevated temperatures.

Animals↗

Biomarkers of lung inflammation in recreational joggers exposed to ozone.

Humans exhibit an acute inflammatory response in the lungs after controlled laboratory exposure to ozone. The present study was designed to test whether biomarkers of inflammation are detectable in humans exposed to ozone and associated copollutants under natural conditions outdoors. Bronchoscopy with bronchoalveolar lavage (BAL) was carried out on 19 normal volunteer joggers from Governors Island, NY, who exercised in the afternoon during the 1992 summer (S1) season. Fifteen subjects were retested during the following, low ozone, winter season (W). The BAL protocol involved an initial instillation of 20 ml saline followed by four sequential 50-ml saline washes carried out in both the right middle lobe and the lingula. The eight 50-ml samples were pooled as the 'alveolar' sample. Analyses performed on the alveolar lavage samples included cell differentials, release of IL-8, TNF-alpha, and reactive oxygen species (ROS) by pooled cells, and levels of IL-8, protein, LDH, fibronectin, alpha1-antitrypsin (alpha1-AT), complement fragment 3a (C3a), and prostaglandin E2 (PGE2) in lavage fluids. Release of ROS by stimulated BAL cells was lower in S1 than in W (p = 0.03). In contrast, LDH levels in BAL fluids were 2-fold higher in S1 than in W (p = 0.02), as were IL-8 (p = 0.12) and PGE2 (p = 0.06). These results suggest a possible ongoing inflammatory response in the lungs of recreational joggers exposed to ozone and associated copollutants during the summer months.

Adult↗

Benefits of exercise training for men with insulin-dependent diabetes mellitus.

Twelve healthy men with IDDM participated in a 12-week walking/jogging exercise program. Pre- and postexercise assessment of dietary intakes, body composition, biochemical measures, and exercise performance indicators were completed. Subjects exercised either 3 or 5 days per week for 1 hour at 60% to 80% of estimated maximal heart rate. Dietary intakes showed a voluntary reduction in fat intake as a percent of total energy from 40% +/- 7% (mean +/- SD) to 37% +/- 8% (P = .053). No change occurred over time in body composition measures except for a significant reduction in the waist-to-hip ratio from 0.87 +/- 0.04 to 0.86 +/- 0.04 (P = .007). Fasting serum glucose and lipid levels did not change over time. Exercise capacity improved, as shown by an increased time to exhaustion on a treadmill run from 7.9 +/- 3.7 minutes to 9.7 +/- 3.8 minutes (P less than .001); and a lower heart rate at a constant work load--from 183 +/- 18 beats per minute preexercise to 175 +/- 20 beats per minute postexercise (P = .022). The study showed that healthy male subjects with IDDM can benefit from regular exercise with a redistribution of body fat and improved exercise capacity.

Adult↗

Foot orthotic devices to modify selected aspects of lower extremity mechanics.

Excessive foot pronation has been speculated to be a cause of leg and foot problems among runners. Foot orthotic devices are often used to modify this condition. Examination of the records of 180 patients treated for various running injuries showed that 83 individuals (46%) were prescribed orthotic devices and that 65 of these runners (78%) were able to return to their previous running programs. In order to assess further the effects of this type of orthotic device, six runners were selected from this group and filmed using two cameras (200 frames/sec) under three conditions: (1) barefoot, (2) regular shoe, and (3) regular shoe plus orthotic device. Both the period of pronation and the amount of maximum pronation were significantly reduced by using the foot orthotic device. The data support the conclusion that foot orthotic devices can be successfully used to modify selected aspects of lower extremity mechanics during the support phase of running.

Ankle↗

Biomechanics of walking, running, and sprinting.

A biomechanical study of 13 runners which consisted of 2 male sprinters, 5 experienced joggers, and 6 elite long-distance runners were studied. We obtained hip, knee, and ankle joints motions in the sagittal plane and electromyographic data from specific muscle groups. As the speed of gait increased, the length of stance phase progressively decreased from 62% for walking to 31% for running and to 22% for sprinting. The sagittal plane motion increased as the speed of gait increased. Generally speaking, the body lowers its center of gravity with the increased speed by increasing flexion of the hips and knees and magnifying dorsiflexion at the ankle joint. Electromyographic activity about the knee demonstrated increased activity in the quadricep muscle group and hamstring group with increased speed. Muscle function about the ankle joint demonstrated that the posterior calf musculature which normally functions during the midstance phase in walking became a late swing phase muscle and was active through the first 80% of stance phase, as compared to 15% in walking. Beside the changes in the electromyographic activity of the muscles, the anterior compartment muscles of the calf undergo a concentric contracture at the time of initial floor contact during running and sprinting but undergo an eccentric contraction during walking.

Ankle Joint↗

Fatigue failure stress of the femoral neck. A case report.

Fatigue fractures are frequent injuries in military populations and occur more frequently in joggers in the civilian population. Repetitive stress below failure levels in a time period inadequate to permit remodeling is known to cause fatigue fractures. However, data on stress levels, the number of cycles to failure, and the time interval in in vivo human fatigue fractures is unknown. We recently treated a patient with a fatigue fracture of the femoral neck and were able to determine this data from patient records and finite element stress analysis. From this data we recommend a maximum total distance of 161 km (100 miles) over a three-month interval for runners who are beginning training. Shorter total distance would be advisable for obese patients.

Adult↗

Deep vein thrombosis in a jogger.

Deep vein thrombosis is rare in young and healthy athletes. A case of venous thrombosis is reported in a young, physically fit jogger.

Adult↗

Acute periostitis in early acquired syphilis simulating shin splints in a jogger.

Acute periostitis affecting the long bones is a characteristic but uncommon manifestation of syphilis in the adult with an early acquired infection. This report describes the history of a jogger who developed acute localized periostitis of the shaft of both tibiae during the early stage of acquired syphilis. Symptomatology was initially attributed to the medial tibial stress syndrome.

Acute Disease↗