ABSTRACT
BACKGROUND: Gastroesophageal reflux (GER) is increasingly recognized as an exacerbating or causal factor in several respiratory diseases. There is a high prevalence of GER in infants with airway malacia. However, such data are lacking in adults. METHODS: This retrospective study was conducted to determine the relationship between GER and excessive central airway collapse (ECAC). The study included consecutive patients with ECAC referred to the Complex Airway Center at Beth Israel Deaconess Medical Center who underwent esophageal pH testing for GER between July 2014 and June 2018. RESULTS: Sixty-three of 139 patients with ECAC (45.3%) had documented GER as shown by an abnormal esophageal pH test result. The mean DeMeester score was 32.2, with a symptom association probability of 39.7% of GER-positive patients. Twenty-nine of 63 patients (46%) with GER reported improvement in respiratory symptoms following maximal medical therapy or antireflux surgery without requiring further treatment for ECAC. CONCLUSIONS: GER is prevalent among patients with ECAC, and aggressive reflux treatment should be considered in these patients prior to considering invasive airway procedures or surgery.
Subject(s)
Esophageal pH Monitoring/methods , Gastroesophageal Reflux , Tracheobronchomalacia , Bronchoscopy/methods , Bronchoscopy/statistics & numerical data , Comorbidity , Esophageal pH Monitoring/statistics & numerical data , Female , Gastroesophageal Reflux/diagnosis , Gastroesophageal Reflux/epidemiology , Gastroesophageal Reflux/physiopathology , Gastroesophageal Reflux/therapy , Humans , Male , Middle Aged , Prevalence , Respiratory System/pathology , Respiratory System/physiopathology , Retrospective Studies , Severity of Illness Index , Tomography, X-Ray Computed/methods , Tomography, X-Ray Computed/statistics & numerical data , Tracheobronchomalacia/diagnosis , Tracheobronchomalacia/epidemiology , Tracheobronchomalacia/physiopathology , United States/epidemiologyABSTRACT
PURPOSE: An active lifestyle is widely recognized as having a beneficial effect on cardiovascular health. However, no clear consensus exists as to whether exercise training increases overall physical activity energy expenditure (PAEE) or whether individuals participating in regular exercise compensate by reducing their off-exercise physical activity. The purpose of this study was to evaluate changes in PAEE in response to aerobic training (AT), resistance training (RT), or combined aerobic and resistance training (AT/RT). METHODS: Data are from 82 participants in the Studies of Targeted Risk Reduction Interventions through Defined Exercise-Aerobic Training versus Resistance Training study, a randomized trial of overweight (body mass index = 25-35 kg·m(-2)) adults, in which participants were randomized to receive 8 months of AT, RT, or AT/RT. All subjects completed a 4-month control period before randomization. PAEE was measured using triaxial RT3 accelerometers, which subjects wore for a 5- to 7-d period before and after the exercise intervention. Data reduction was performed with a previously published computer-based algorithm. RESULTS: There was no significant change in off-exercise PAEE in any of the exercise training groups. We observed a significant increase in total PAEE that included the exercise training, in both AT and AT/RT but not in RT. CONCLUSIONS: Eight months of exercise training was not associated with a compensatory reduction in off-exercise physical activity, regardless of exercise modality. The absence of compensation is particularly notable for AT/RT subjects, who performed a larger volume of exercise than did AT or RT subjects. We believe that the extended duration of our exercise training program was the key factor in allowing subjects to reach a new steady-state level of physical activity within their daily lives.