RESUMEN
Impaired cardiorespiratory fitness is associated with inferior survival in patients preparing to undergo hematopoietic cell transplantation (HCT). Exercise training based on short, higher intensity intervals has the potential to efficiently improve cardiorespiratory fitness. We studied home-based interval exercise training (IET) in 40 patients before autologous (N=20) or allogeneic (N=20) HCT. Each session consisted of five, 3 min intervals of walking, jogging or cycling at 65-95% maximal heart rate (MHR) with 3 min of low-intensity exercise (<65% MHR) between intervals. Participants were asked to perform sessions at least three times weekly. The duration of the intervention was at least 6 weeks, depending on each patient's scheduled transplantation date. Cardiorespiratory fitness was assessed from a peak oxygen consumption test (VO2peak) and a 6 min walk (6MWD) before and after the intervention period. For the autologous HCT cohort, improvements in VO2peak (P=0.12) and 6MWD (P=0.19) were not statistically significant. For the allogeneic cohort, the median VO2peak improvement was 3.7 ml/kg min (P=0.005) and the median 6MWD improvement was 34 m (P=0.006). Home-based IET can be performed before HCT and has the potential to improve cardiorespiratory fitness.
Asunto(s)
Capacidad Cardiovascular/fisiología , Ejercicio Físico/fisiología , Trasplante de Células Madre Hematopoyéticas/métodos , Servicios de Atención de Salud a Domicilio , Anciano , Femenino , Frecuencia Cardíaca , Trasplante de Células Madre Hematopoyéticas/mortalidad , Entrenamiento de Intervalos de Alta Intensidad/métodos , Humanos , Masculino , Persona de Mediana Edad , Consumo de Oxígeno/fisiología , CaminataRESUMEN
A census, uniform screening questionnaire and simple screening neurologic examination were administered door to door to the 221 residents of Paluguillo, a rural migrant community near Quito, Ecuador. This protocol was pretested to assure a high level of sensitivity for detecting major neurologic diseases in both children and adults. Of the participants, 119 (54%) had responses or findings suggesting the presence of neurologic disease, and, in particular, 53 (24%) had responses suggestive of epilepsy. These individuals were then examined by neurologists using fixed diagnostic criteria. The prevalence ratio for epilepsy was found to be 22.6/1,000. The results of this survey support the conclusion that epilepsy has a higher prevalence in rural areas of socioeconomically deprived countries than it does in industrialized nations.