Effects of a short-term differently dosed aerobic exercise on maximum aerobic capacity in breast cancer survivors: a pilot study.

BACKGROUND/AIM: Regular physical activity and exercise improves quality of life and possibly reduces risk of disease relapse and prolongs survival in breast cancer survivors. The aim of this study was to evaluate the impact of a 3-week moderate intensity aerobic training, on aerobic capacity (VO2max) in breast cancer survivors. METHODS: A prospective, randomized clinical study included 18 female breast cancer survivors in stage I-IIIA, in which the primary treatment was accomplished at least 3 months before the study inclusion. In all the patients VO2max was estimated using the Astrand's protocol on a bicycle-ergometer (before and after 3 weeks of training), while subjective assessment of exertion during training were estimated by the Category-Ratio RPE Scale. Each workout lasted 21 minutes: 3 minutes for warm-up and cool-down each and 15 min of full training, 2 times a week. The workload in the group E1 was predefined at the level of 45% to 65% of individual VO2max, and in the group E2 it was based on subjective evaluation of exertion, at the level marked 4-6. Data on the subjective feeling of exertion were collected after each training course in both groups. RESULTS: We recorded a statistically significant improvement in VO2max in both groups (E1--11.86%; E2--17.72%), with no significant differences between the groups. The workload level, determined by the percent of VO2max, was different between the groups E1 and E2 (50.47 +/- 7.02% vs 55.58 +/- 9.58%), as well as subjective perception of exertion (in the groups E1 and E2, 11.6% and 41.6% of training, respectively, was graded in the mark 6). CONCLUSION: In our group of breast cancer survivors, a 3-week moderate intensity aerobic training significantly improved the level of VO2max.

[Effect of iron supplementation on maximal oxygen uptake in female athletes].

BACKGROUND/AIM: Iron is a vital constituent of hemoglobin, myoglobin, and some mitochondrial enzymes; therefore, body iron deficiency may result in reduced aerobic capacity. The aim of this study was to evaluate the effects of daily oral iron supplementation on body iron status, and the maximal oxygen uptake (VO2max) in female athletes with latent iron deficiency, as well as with iron-deficiency anemia. METHODS: A total of 37 female volleyball players were included in the study. Seventeen female athletes had latent iron deficiency, and 20 ones iron deficiency anemia. Both groups were divided into the experimental and the control group. The experimental groups received a daily oral iron supplement (200 mg ferrous sulfate), for a two-month training course. Iron status was determined by serum parameters as follows: red blood cells count, hemoglobin concentration, serum iron and ferritin levels, an unsaturated iron binding capacity, total iron binding capacity and transferrin saturation. VO2max was determined by an indirect test. RESULTS: Statistical difference between the latent iron deficient group versus the iron deficient anemic group was found regarding VO2max (p < 0.001). There were correlations between hemoglobin concentration and VO2max in the latent iron deficient group, as well as in the iron deficient anaemic group (p < 0.05). After two months, there was a significant increase in VO2max in all groups (from 7.0% to 18.2%). Values of VO2max at the end of training period were significantly different (45.98 +/- 1.76 vs 42.40 +/- 1.22 mL/kg/min; p < 0.001) between the experimental and the control group only in female athletes with iron deficiency anemia. After the supplementation, markers of iron status were significantly higher in supplemented groups than in the controls. CONCLUSION: VO2max was significantly lower in the iron deficient anemic group versus the latent iron deficient group. Iron supplementation during a two-month training period significantly improved body iron status in the iron deficient female athletes with or without anemia, and significantly increased VO2max only in the subjects with iron deficiency anemia.

[Examination of cardiovascular function variables in tooth extraction under local anesthesia].

BACKGROUND/AIM: Local anesthesia is the one of the most used procedures in surgical practice. It is used for toot extraction to produce analgesic and anesthetic effects. However, there is a question if it is equally safe to apply a local anesthetic combined with a vasoconstrictor (adrenaline) in healthy persons, and in the patients with a certain cardiovasccular system disease. The aim of this stady was to determine whether there were differences in cardiovascular variables during tooth extraction in healthy persons, and in cardiovascular patients when an anesthetic was applyted with adrenaline, or without it. METHODS: The examinees were divided into the group with cardiovascular diseases (CV, n=57) of H and III type, according to the American Society of Anesthesiologists (ASA) qualification, and healthy persons (H, n=55). Both groups were randomly divided into two subgroups: CVa and Ha--where the anesthetic solution had the vasoconstrictor (3% lidocaine, and 1: 100,000 adrenaline); CVb and Hb--where the anesthetic solution was without the vasoconstrictor (3% lidocaine). During the preparation for tooth extraction, the application of anesthetics, extraction and relaxation puls (fc), systolic (TAs) and diastolic arterial blood pressure (TAd) and ECG were registered. RESULTS: The values of fc did not significantly differ among the groups in any measured term. The values of systolic and diastolic blood pressure in the groups CVa and CVb were significantly higher in all the terms of measuring (p < 0.05) from the values in the groups Ha and Hb. A significant increase of TAs was registered only in the phase of tooth extraction in the CVa and CVb group (< 0.05). The values of TAd did not significantly differ between the groups in all the measured terms. Extrasystolic beats were registered in 11 patients of the CV group and in 7 patients of the H group in the phase of anesthetic application or tooth extraction. CONCLUSION: This research shoved that tooth extraction under local anesthesia did not cause complications in cardiovascular patients who were in II or III ASA qualification group, regardless the presence of a vasoconstrictor in the local anesthetic solution.

[The effects of pulsed low frequency magnetic field in early rehabilitation of patients with cementless total hip arthroplasty].

INTRODUCTION: Early rehabilitation of patients with cementless total hip arthroplasty (cTHA) includes different physical modalities and pulsed low frequency magnetic field (PLFMF), which effects have not been explored yet. OBJECTIVE: To investigate the effects of PLFMF which was applied in different doses in early rehabilitation of patients with METHOD: Prospective, controlled, clinical study included 90 patients, divided in three groups with 30 patients each. First two groups were treated with high (group A) or low (group B) doses of PLFMF, in addition to kinesitherapy. Control group C was treated only with kinesitherapy. Study was completed in three weeks. RESULTS: Subjects of group A had significantly lower pain than group B (p < 0.01) and group C (p < 0.001) subjects in the first postoperative week. Pain in group B subjects was significantly lower than in group C in all three postoperative weeks (p < 0.01). In relation to other two groups, subjects of group A had higher hip Harris score values at the end of the third post-operative week (p < 0.05), and they were faster on 10-meter distance at the end of the first postoperative week (p < 0.01). CONCLUSION: PLFMF used in low and high doses for patients with cTHA had significant effects on pain abatement, especially at higher doses. Improvement of function was earlier and more manifested in the group treated with high doses of PLFMF.

[Influence of orlistat therapy on serum insulin level and morphological and functional parameters of peripheral arterial circulation in obese patients].

BACKGROUND/AIM: Insulin resistance is related to accelerated atherosclerosis, whereas weight loss is associated with the increasing insulin sensitivity, the improvement of functional and the morphological parameters of arterial circulation, and the reduction of cardiovascular morbidity and mortality. The aim of our study was to evaluate the influence of orlistat treatment on serum insulin level and functional and morphologic parameters of peripheral arterial circulation. METHODS: We conducted a prospective, randomized, double - blind, placebo - controlled study. Thirty patients with body mass index over 30 kg/m2 normotensive, nonsmokers, without clinically manifested cardiovascular disease or diabetes were randomly assigned either orlistat (120 mg, 3 times daily; n = 20) or placebo (n = 10) in a double - blind manner. All of the patients were on individually calculated hypocaloric diet. The follow-up period was 24 weeks. Arterial pressure, fasting serum glucose and insulin level, triglycerides, total cholesterol and low density lipoprotein-cholesterol were determined at the beginning, following 3 and 6 months. Also, the intima - media thickness of right superficial femoral artery and the mean blood flow velocity were determined with ultrasonography. RESULTS: Inside the period of 3 and 6 months, there were the greater reductions of body mass index, arterial pressure, fasting glucose and insulin level, total cholesterol, low density lipoproteins, as well as the greater reductions of mean velocity blood flow and peripheral pulse pressure in the orlistat group vs the placebo group (p < 0.01). Greater reductions in the waist circumference and intima - media thickness were registered following 6 months in the orlistat vs the placebo group (p < 0.01). CONCLUSION: In the group of obese patients orlistat therapy reduced risk factors, serum insulin level and improved early arterial functional changes as assessed with the reductions of the mean velocity blood flow and peripheral pulse pressure following 3 months. The regression of morphological changes, as assessed with the reduction in intima - media thickness, was feasible over the six - month period.

[Effects of circumferential rigid wrist orthoses in rehabilitation of patients with radius fracture at typical site].

BACKGROUND: The use of orthoses is a questionable rehabilitation method for patients with the distal radius fracture at typical site. The aim of this study was to compare the effects of the rehabilitation on patients with radius fracture at the typical site, who wore circumferential static wrist orthoses, with those who did not wear them. METHODS: Thirty patients were divided into 3 equal groups, 2 experimental groups, and 1 control group. The patients in the experimental groups were given the rehabilitation program of wearing serially manufactured (off-the-shelf), as well as custom-fit orthoses. Those in the control group did not wear wrist orthoses. Evaluation parameters were pain, edema, the range of the wrist motion, the quality of cylindrical, spherical, and pinch-spherical grasp, the strength of pinch and hand grasp, and patient's assessment of the effects of rehabilitation. RESULTS: No significant difference in the effects of rehabilitation on the patients in experimental groups as opposed to control group was found. Patients in the first experimental group, and in control group were more satisfied with the effects of rehabilitation, as opposed to the patients in the second experimental group (p<0.05). CONCLUSION: The effects of circumferential static wrist orthoses in the rehabilitation of patients with distal radius fracture at the typical site were not clinically significant. There was no significant difference between the custom and off-the-shelf orthoses.

[Effect of a two-week program of individually monitored physical activity on insulin resistance in obese non-insulin-dependent diabetics]. / Efekti dvonedeljnog programa individualno dozirane fizicke aktivnosti na insulinsku rezistenciju kod gojaznih insulin-nezavisnih dijabeticara.

It is well known that under the influence of regular, individually measured aerobic physical activity, it is possible to raise the biological efficiency of insulin by several mechanisms: by increasing the number of insulin receptors, their sensitivity and efficiency, as well as by increasing glucose transporters GLUT-4 on the level of cell membrane. The aim of this research was to examine whether decreased insulin resistance could be achieved under the influence of the program of individually measured aerobic physical activity in the 2-week period, in the obese type 2 diabetes patients with the increased aerobic capacity (VO2)max. In 10 type 2 diabetes patients 47.6 +/- 4.6 years of age (group E), in the 14-days period, program of aerobic training was applied (10 sessions--35 min session of walking on treadmill, intensity 60.8 +/- 5.7% (VO2)max, frequency 5 times a week), as well as 1,600 kcal diet. At the same time, other 10 type 2 diabetes patients 45.9 +/- 5.5 years of age (group C) were on 1,600 kcal diet. Before and after this period the following was measured in both groups: insulin sensitivity (M/I) by the method of hyperinsulin euglycemic clamp, and (VO2)max by Astrand test on ergocycle. In contrast to the group C, in the second testing of E group subjects a significant increase was obtained in M/I (1.23 +/- 0.78 vs. 2.42 +/- 0.95 mg/kg/min/mU p < 0.001, 96.75%) as well as the increase of (VO2)max (26.34 +/- 4.26 vs. 29.16 +/- 5.01 ml/kg/min p < 0.05, 10.7%). The results had shown that 2-week program of aerobic training had had significant influence on the increased aerobic capacity and insulin sensitivity in the tested patients.