948 resultados para Cardiopulmonary Exercise Testing
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It is well known that cointegration between the level of two variables (labeled Yt and yt in this paper) is a necessary condition to assess the empirical validity of a present-value model (PV and PVM, respectively, hereafter) linking them. The work on cointegration has been so prevalent that it is often overlooked that another necessary condition for the PVM to hold is that the forecast error entailed by the model is orthogonal to the past. The basis of this result is the use of rational expectations in forecasting future values of variables in the PVM. If this condition fails, the present-value equation will not be valid, since it will contain an additional term capturing the (non-zero) conditional expected value of future error terms. Our article has a few novel contributions, but two stand out. First, in testing for PVMs, we advise to split the restrictions implied by PV relationships into orthogonality conditions (or reduced rank restrictions) before additional tests on the value of parameters. We show that PV relationships entail a weak-form common feature relationship as in Hecq, Palm, and Urbain (2006) and in Athanasopoulos, Guillén, Issler and Vahid (2011) and also a polynomial serial-correlation common feature relationship as in Cubadda and Hecq (2001), which represent restrictions on dynamic models which allow several tests for the existence of PV relationships to be used. Because these relationships occur mostly with nancial data, we propose tests based on generalized method of moment (GMM) estimates, where it is straightforward to propose robust tests in the presence of heteroskedasticity. We also propose a robust Wald test developed to investigate the presence of reduced rank models. Their performance is evaluated in a Monte-Carlo exercise. Second, in the context of asset pricing, we propose applying a permanent-transitory (PT) decomposition based on Beveridge and Nelson (1981), which focus on extracting the long-run component of asset prices, a key concept in modern nancial theory as discussed in Alvarez and Jermann (2005), Hansen and Scheinkman (2009), and Nieuwerburgh, Lustig, Verdelhan (2010). Here again we can exploit the results developed in the common cycle literature to easily extract permament and transitory components under both long and also short-run restrictions. The techniques discussed herein are applied to long span annual data on long- and short-term interest rates and on price and dividend for the U.S. economy. In both applications we do not reject the existence of a common cyclical feature vector linking these two series. Extracting the long-run component shows the usefulness of our approach and highlights the presence of asset-pricing bubbles.
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PURPOSE: To investigate if tests used in the preoperative period of upper abdominal or thoracic surgeries are able to differentiate the patients that presented cardiopulmonary postoperative complications. METHODS: Seventy eight patients, 30 submitted to upper abdominal surgery and 48 to thoracic surgery were evaluated. Spirometry, respirometry, manovacuometry, six-minute walk test and stair-climbing test were performed. Complications from immediate postoperative to discharge from hospital were registered. RESULTS: The postoperative complications rate was 17% in upper abdominal surgery and 10% in thoracic surgery. In the univariate regression, the only variable that kept the correlation with postoperative complications in the upper abdominal surgery was maximal expiratory pressure. In thoracic surgery, the maximal voluntary ventilation, six-minute walk test and time in stair-climbing test presented correlation with postoperative complications. After multiple regression only stair-climbing test continued as an important risk predictor in thoracic surgery. CONCLUSION: The respiratory pressure could differentiate patients with complications in upper abdominal surgery, whereas in thoracic surgery, only spirometric values and exercise tests could differentiate them.
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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
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We report the results of the seventh edition of the GEP-ISFG mitochondrial DNA (mtDNA) collaborative exercise. The samples submitted to the participant laboratories were blood stains from a maternity case and Simulated forensic samples, including a case of mixture. The success rate for the blood stains was moderate (similar to 77%); even though four inexperienced laboratories concentrated about one-third of the total errors. A similar success was obtained for the analysis of mixed samples (78.8% for a hair-saliva mixture and 69.2% for a saliva-saliva Mixture). Two laboratories also dissected the haplotypes contributing to the saliva-saliva mixture. Most of the errors were due to reading problems and misinterpretation of electropherograms, demonstrating once more that the lack of a solid devised experimental approach is the main cause of error in mtDNA testing. (C) 2007 Elsevier B.V. All rights reserved.
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The purpose of this study was to investigate the influence of exercise order on one-repetition maximum (1-RM) and ten-repetition maximum (10-RM) strength gains after 6 weeks of resistance training (RT) in trained men. Sixteen men were randomly assigned into two groups based on the order of exercises performed during training sessions: a group that performed large muscle group exercises first and progressed to small muscle group exercises (LG-SM); while a second group performed the opposite sequence and started with small muscle group exercises and progressed to large muscle group exercises (SM-LG). Four sessions of RT were conducted per week; all exercises were performed for three sets of 8-12 repetitions with 1-min rest intervals between sets. Maximal and submaximal strength were assessed at baseline and after 6 weeks of RT with 1-RM and 10-RM testing for the bench press (BP), lat pulldown (LPD), triceps pulley extension (TE) and biceps curl (BC), respectively. Two-way ANOVA for the 1-RM and 10-RM tests indicated a significant group x time interaction. The 1-RM values significantly increased for all exercises in both groups (P<0.05), but were not significantly different between groups. However, effect size (ES) data indicated that the LG-SM group exhibited a greater magnitude of gains (1-RM and 10-RM) for the BP and LPD exercises. Conversely, ES indicated that the SM-LG group exhibited a greater magnitude of gains (1-RM and 10-RM) for the TE and BC exercises. In conclusion, the results suggest that upper body movements should be prioritized and performed according to individual needs to maximize maximal and submaximal strength. © 2013 Scandinavian Society of Clinical Physiology and Nuclear Medicine.
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Coordenação de Aperfeiçoamentode Pessoal de Nível Superior (CAPES)
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Colombian Reference National Laboratory, GENES LTDA, have organized and coordinated for the past two years (2009 and 2010) the Quality Control Exercise for laboratories undertaking paternity, maternity and forensic tests with DNA markers. Twenty-two laboratories have participated in 2009, increasing the number to 27 in 2010. Laboratories in Colombia, Brazil, Ecuador, Peru, Dominican Republic and Panama have participated in these exercises. There have been some similarities in the two controls: A practical exercise, three blood samples on FTA cards were sent to each participating laboratory to be genotyped for DNA markers using the routine methodologies in their laboratories; theoretical exercises including optional and obligatory cases. For the theoretical exercises, the participating laboratories should calculate the partial and final PI or BRI (Biological Relationship Index or Paternity Index). Forty-nine and 52 markers were under consensus for 2009 and 2010, respectively, distributed in autosomal, Y and X chromosomes STR. With respect to 2008, 12 and 15 additional markers were under consensus for 2009 and 2010, respectively. The rate of reporting error was 2.9% in 2009 while in 2010, 4.7% error was reported. The Proficiency Test conducted through the Colombian National Reference Laboratory has become a useful tool for quality assurance of all Colombian laboratories and some of Latin America that do DNA testing to establish biological relationships and an excellent opportunity for ongoing training of experts from the region.
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Speeding the VO2 kinetics results in a reduction of the O2 deficit. Two factors might determine VO2 kinetics: oxygen delivery to muscle (Tschakovsky and Hughson 1999) and a muscle 'metabolic inertia' (Grassi et al. 1996). Therefore, in study 1 we investigated VO2 kinetics and cardiovascular system adaptations during step exercise transitions in different regions of the moderate domain. In study 2 we investigated muscle oxygenation and cardio-pulmonary adaptations during step exercise tests before, after and over a period of training. Study 1 methods: Seven subjects (26 ± 8 yr; 176 ± 5 cm; 69 ± 6 kg) performed 4 types of step transition from rest (0-50W; 0-100W) or elevate baseline (25-75W; 25-125W). GET and VO2max were assessed before testing. O2 uptake and were measured during testing. Study 2 methods: 10 subjects (25 ± 4 yr; 175 ± 9 cm; 71 ± 12 kg) performed a step transition test (0 to 100 W) before, after and during 4 weeks of endurance training (ET). VO2max and GET were assessed before and after of ET (40 minutes, 3 times a week, 60% O2max). VO2 uptake, Q and deoxyheamoglobin were measured during testing. Study 1 results: VO2 τ and the functional gain were slower in the upper regions of the moderate domain. Q increased more abruptly during rest to work condition. Q τ was faster than VO2 τ for each exercise step. Study 2 results: VO2 τ became faster after ET (25%) and particularly after 1 training session (4%). Q kinetics changed after 4 training sessions nevertheless it was always faster than VO2 τ. An attenuation in ∆[HHb] /∆VO2 was detectible. Conclusion: these investigations suggest that muscle fibres recruitment exerts a influence on the VO2 response within the moderate domain either during different forms of step transition or following ET.
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The aim of this study was to assess the effects on exercise performance of supplementing a standard cardiac rehabilitation program with additional exercise programming compared to the standard cardiac rehabilitation program alone in elderly patients after heart surgery.
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Exertional oscillatory ventilation (EOV) is an ominous prognostic sign in chronic heart failure (CHF), but little is known about the success of specific therapeutic interventions. Our aim was to study the impact of an exercise training on exercise capacity and cardiopulmonary adaptation in stable CHF patients with left ventricular systolic dysfunction and EOV. 96 stable CHF patients with EOV were included in a retrospective analysis (52 training versus 44 controls). EOV was defined as follows: 1) three or more oscillatory fluctuations in minute ventilation (V'(E)) during exercise; 2) regular oscillations; and 3) minimal average ventilation amplitude ≥5 L. EOV disappeared in 37 (71.2%) out of 52 patients after training, but only in one (2.3%) out of 44 without training (p<0.001). The decrease of EOV amplitude correlated with changes in end-tidal carbon dioxide tension (r= -0.60, p<0.001) at the respiratory compensation point and V'(E)/carbon dioxide production (V'(CO(2))) slope (r=0.50, p<0.001). Training significantly improved resting values of respiratory frequency (f(R)), V'(E), tidal volume (V(T)) and V'(E)/V'(CO(2)) ratio. During exercise, V'(E) and V(T) reached significantly higher values at the peak, while f(R) and V'(E)/V'(CO(2)) ratio were significantly lower at submaximal exercise. No change was noted in the control group. Exercise training leads to a significant decrease of EOV and improves ventilatory efficiency in patients with stable CHF.
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Permission from the ethics committee and informed consent were obtained. The purpose of this study was to prospectively evaluate a method developed for the noninvasive assessment of muscle metabolites during exercise. Hydrogen 1 magnetic resonance (MR) spectroscopy peaks were measured during tetanic isometric muscle contraction imposed by supramaximal repetitive nerve stimulation. The kinetics of creatine-phosphocreatine and acetylcarnitine signal changes (P < .001) could be assessed continuously before, during, and after exercise. The control peak (trimethylammonium compounds), which served as an internal reference, did not change. This technique-that is, functional MR spectroscopy-opens the possibility for noninvasive diagnostic muscle metabolite testing in a clinical setting.
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The objective of this study was to determine the effect of wearing a mouthguard on maximal exercise capacity and cardiopulmonary parameters at peak workload, and to assess the athletes' attitudes toward wearing a mouthguard. Thirteen volunteer male athletes (18 to 27 years old) were interviewed before and after delivery of a custom-made laminated mouthguard. A visual analogue scale (VAS, 0 - 100 mm) was used for judgment of interference with breathing, speaking, concentration and athletic performance. In addition, the athletes were subjected to a cardiorespiratory examination on a cycle ergometer with and without mouthguards. Subjectively, the athletes rated the mean interference with performance to be 37 mm VAS at the beginning of the study. Mean scores of impairment decreased to 23 mm VAS (p = 0.081) after wearing the mouthguard for four weeks, and further improved to 12 mm VAS (p < 0.001) after the test on the cycle ergometer. Objectively, the maximum workload during spiroergometry was even slightly elevated during exercise with the mouthguard (330.2 W) compared to exercise without the mouthguard (314.5 W). Peak minute ventilation and oxygen uptake were not different during exercise with and without the mouthguard. The present study demonstrated that a custom-made mouthguard does not significantly affect or reduce maximum exercise performance of athletes.
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Recently, a new oxygenator (Dideco 903 [D903], Dideco, Mirandola, Italy) has been introduced to the perfusion community, and we set about testing its oxygen transfer performance and then comparing it to two other models. This evaluation was based on the comparison between oxygen transfer slope, gas phase arterial oxygen gradients, degree of blood shunting, maximum oxygen transfer, and diffusing capacity calculated for each membrane. Sixty patients were randomized into three groups of oxygenators (Dideco 703 [D703], Dideco; D903; and Quadrox, Jostra Medizintechnik AG, Hirrlingen, Germany) including 40/20 M/F of 68.6 +/- 11.3 years old, with a body weight of 71.5 +/- 12.1 kg, a body surface area (BSA) of 1.84 +/- 0.3 m(2), and a theoretical blood flow rate (index 2.4 times BSA) of 4.4 +/- 0.7 L/min. The maximum oxygen transfer (VO(2)) values were 313 mL O(2)/min (D703), 579 mL O(2)/min (D903), and 400 mL O(2)/min (Quadrox), with the D903 being the most superior (P < 0.05). Oxygen (O(2)) gradients were 320 mm Hg (D703), 235 mm Hg (D903), and 247 mm Hg (Quadrox), meaning D903 and Quadrox are more efficient versus the D703 (P < 0.05). Shunt fraction (Qs/Qt) and diffusing capacity (DmO(2)) were comparable (P = ns). Diffusing capacity values indexed to BSA (DmO(2)/m(2)) were 0.15 mL O(2)/min/mm Hg/m(2) (D703), 0.2 mL O(2)/min/mm Hg/m(2) (D903), and 0.18 mL O(2)/min/mm Hg/m(2) (Quadrox) with D903 outperforming D703 (P < 0.0005). During hypothermia (32.0 +/- 0.3 degrees C), there was a lower absolute and relative VO(2 )for all three oxygenators (P = ns). The O(2) gradients, DmO(2) and DmO(2)/m(2), were significantly lower for all oxygenators (P < 0.01). Also, Qs/Qt significantly rose for all oxygenators (P < 0.01). The oxygen transfer curve is characteristic to each oxygenator type and represents a tool to quantify oxygenator performance. Using this parameter, we demonstrated significant differences among commercially available oxygenators. However, all three oxygenators are considered to meet the oxygen needs of the patients.
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BACKGROUND: Left anterior hemiblock (LAHB) is the most frequent conduction abnormality, but its impact on the diagnostic accuracy of the exercise ECG has not been studied. The aim of our study was to determine the diagnostic accuracy of ST depression for predicting ischaemia in the presence of LAHB. PATIENTS: Consecutive patients with known or suspected coronary heart disease undergoing exercise ECG and 99mTc-sestamibi single photon emission computed tomography (SPECT) were included in the analysis. Patients with left bundle branch block, with changes in QRS morphology related to myocardial infarction, and patients who had undergone pharmacological stress testing were excluded. RESULTS: Of 1532 patients assessed, 567 patients qualified for the analysis. In 69 patients with LAHB, ECG stress testing had lower sensitivity (38% vs 86%) and lower negative predictive value (82% vs 92%) than in patients with normal baseline ECG. The reduction of sensitivity appeared to be similar in patients with isolated LAHB (n=43), in patients with right bundle branch block (n=39), and with bifascicular block (n=26). In contrast, the positive predictive value of the test was excellent. CONCLUSION: The diagnostic accuracy of the exercise ECG for prediction of ischaemia is reduced in patients with LAHB.