Differences between FEV6, FVC and VC at the diagnosis of obstructive ventilatory defect.

INTRODUCTION: The diagnosis of airway obstruction can be made through FEV1/FVC ratio <0.7 or FEV1/VC ratio < lower limit of normality (LLN). Several authors advocate that FEV1/FEV6 ratio is an alternative to diagnosing obstructive ventilatory defect, while others have determined that the best cut-off for this ratio (best combined sensitivity and specificity) is 0.73. OBJECTIVE: To evaluate the non-inferiority of FEV1/FEV6 ratio < 0.73 when compared to FEV1/FVC ratio < 0.7 and FEV1/VC < LLN in diagnosing airway obstruction. METHODS: A retrospective analysis of the medical records from patients who underwent spirometry or plethysmography in a university central hospital from June 1st to December 31st, 2018 was carried out. Only medical records which included FEV1/FVC < 0.7 or FEV1/VC < LLN were selected, and these results were compared to FEV1/FEV6 ratio. RESULTS: A total of 526 patients with obstructive ventilatory defect were identified by one of the two ratios described. Of these, 95.1%, 87.4% and 88.6% were obstructive by FEV1/FVC, FEV1/VC, and FEV1/FEV6 ratio, respectively. The positive predictive value (PPV) of FEV1/FEV6 in relation to FEV1/FVC ratio was 99.6% (p < 0.001) with a diagnostic efficacy of 92.8%, whereas the PPV of FEV1/FEV6 in relation to FEV1/VC was 91.0% (p < 0.001) and diagnostic efficacy was 85.2%. Most false negatives, comparing FEV6 with the other two tests, were found in patients with FEV1 > 70% (mild obstruction) and in individuals aged >50 years. CONCLUSIONS: FEV1/FEV6 < 0.73 may be a good alternative ratio, as it is non-inferior to FEV1/VC and FEV1/FVC in diagnosing obstructive ventilatory defect.

Swimming exercise demonstrates advantages over running exercise in reducing proteinuria and glomerulosclerosis in spontaneously hypertensive rats.

Experimental studies in animal models have described the benefits of physical exercise (PE) to kidney diseases associated with hypertension. Land- and water-based exercises induce different responses in renal function. Our aim was to evaluate the renal alterations induced by different environments of PE in spontaneously hypertensive rats (SHRs). The SHRs were divided into sedentary (S), swimming exercise (SE), and running exercise (RE) groups, and were trained for 8 weeks under similar intensities (60 min/day). Arterial pressure (AP) and heart rate (HR) were recorded. The renal function was evaluated through urinary volume at each week of training; sodium and potassium excretions, plasma and urinary osmolarities, glomerular filtration rate (GFR), levels of proteinuria, and renal damage were determined. SE and RE rats presented reduced mean AP, systolic blood pressure, and HR in comparison with S group. SE and RE rats showed higher urine osmolarity compared with S. SE rats showed higher free water clearance (P < 0.01), lower urinary density (P < 0.0001), and increased weekly urine volume (P < 0.05) in comparison with RE and S groups. GFR was increased in both SE and RE rats. The proteinuria of SE (7.0 ± 0.8 mg/24 h) rats was decreased at the 8th week of the PE in comparison with RE (9.6 ± 0.8 mg/24 h) and S (9.8 ± 0.5 mg/24 h) groups. The glomerulosclerosis was reduced in SE rats (P < 0.02). SE produced different response in renal function in comparison with RE, in which only swimming-trained rats had better profile for proteinuria and glomerulosclerosis.

Magnetic resonance diffusion tensor imaging for the pedunculopontine nucleus: proof of concept and histological correlation.

The pedunculopontine nucleus (PPN) has been proposed as target for deep brain stimulation (DBS) in patients with postural instability and gait disorders due to its involvement in muscle tonus adjustments and control of locomotion. However, it is a deep-seated brainstem nucleus without clear imaging or electrophysiological markers. Some studies suggested that diffusion tensor imaging (DTI) may help guiding electrode placement in the PPN by showing the surrounding fiber bundles, but none have provided a direct histological correlation. We investigated DTI fractional anisotropy (FA) maps from in vivo and in situ post-mortem magnetic resonance images (MRI) compared to histological evaluations for improving PPN targeting in humans. A post-mortem brain was scanned in a clinical 3T MR system in situ. Thereafter, the brain was processed with a special method ideally suited for cytoarchitectonic analyses. Also, nine volunteers had in vivo brain scanning using the same MRI protocol. Images from volunteers were compared to those obtained in the post-mortem study. FA values of the volunteers were obtained from PPN, inferior colliculus, cerebellar crossing fibers and medial lemniscus using histological data and atlas information. FA values in the PPN were significantly lower than in the surrounding white matter region and higher than in areas with predominantly gray matter. In Nissl-stained histologic sections, the PPN extended for more than 10 mm in the rostro-caudal axis being closely attached to the lateral parabrachial nucleus. Our DTI analyses and the spatial correlation with histological findings proposed a location for PPN that matched the position assigned to this nucleus in the literature. Coregistration of neuroimaging and cytoarchitectonic features can add value to help establishing functional architectonics of the PPN and facilitate neurosurgical targeting of this extended nucleus.

Effects of partial-body cryotherapy (- 110°C) on muscle recovery between high-intensity exercise bouts.

The aim of this study was to evaluate the effects of a single partial-body cryotherapy bout between training sessions on strength recovery. 12 young men (23.9±5.9 years) were randomly exposed to 2 different conditions separated by 7 days: 1) Partial-body cryotherapy (subjects were exposed to 3 min of partial-body cryotherapy at - 110 °C between 2 high-intensity training sessions); 2) Control (subjects were not exposed to partial-body cryotherapy between 2 high-intensity training sessions). Subjects were exposed to partial-body cryotherapy after the first training session. The 2 knee extension high-intensity training sessions were separated by a 40-min rest interval. Knee extension training consisted of 6 sets of 10 repetitions at 60°.s(-1) for concentric actions and 6 sets of 10 at 180.s(-1) for eccentric actions. The decrease in eccentric peak torque and total work was significantly (p<0.05) less after partial-body cryotherapy (5.6 and 2%, respectively) when compared to control (16 and 11.6%, respectively). However, the decrease in concentric peak torque and total work was not different (p>0.05) between partial-body cryotherapy (9.4 and 6.5%, respectively) and control (7.5 and 5.2%, respectively). These results indicate that the use of partial-body cryotherapy between-training sessions can enhance eccentric muscle performance recovery.

Head hair reduces sweat rate during exercise under the sun.

The purpose of this study was to evaluate the effects of human head hair on thermoregulation during exercise carried out under solar radiation. 10 healthy male subjects (mean±SD: 25.1±2.5 yr; height: 176.2±4.0 cm; weight: 73.7±6.7 kg; VO(2max) 56.2±5.3 mLO(2)·kg (-1)·min (-1)) took part in 2 1 h-long trials of continuous exercise on a treadmill at 50% VO2(max) under solar radiation that were separated by at least 2 days. Whereas for the first trial they retained their natural head hair (HAIR), in the second trial their hair was totally shaved (NOHAIR). Several properties were measured, including environmental heat stress (Wet Bulb Globe Temperature index - WBGT, °C), heart rate, rectal temperature, skin temperature, head temperature, and global sweat rate. The main findings were that whereas there was a lower sweat rate in the HAIR condition (HAIR: 7.08±0.79 vs. NOHAIR: 7.67±0.79 g·m (-2)·min (-1); p=0.03), there were no significant differences in any of the other variables between the HAIR and NOHAIR trials. In conclusion, the presence of head hair resulted in a lower sweat rate.

Competition, estimated, and test maximum heart rate.

AIM: The aim of the present study was to compare the highest heart rate (HR) of soccer players recorded during competition matches with the maximum HR (HR(max)) estimated from age and the highest HR recorded in effort tests within a single category (intracategory) and between categories (intercategories). METHODS: The sample was made up of 19 under-17 athletes, 12 under-20 athletes and 14 professional athletes of a Brazilian first division soccer team. Players' HR was monitored during official competition matches and maximum effort test with a set of HR monitors. The highest HR recorded during competitive matches (MHR1) was considered as the highest HR value attained by each player during matches. HR(max) estimated from age (MHR2) was estimated by using the equation HR(max)= (220-age). The highest HR recorded in effort tests (MHR3) was determined as being the highest HR value recorded during a maximum effort test (1 000-m run). The Wilcoxon test was used in intracategory statistical analysis. The Kruskal Wallis test was used in intercategory statistical analysis. The significance level adopted was P<0.05. RESULTS: In all categories, MHR3 was lower than MHR1. Concerning intercategory analysis, the three categories did not exhibit a difference in MHR1 RESULTS: Relative to MHR3, the under-17 and under-20 categories were not different from each other. These two categories exhibited larger MHR3 values than the professional one did. CONCLUSION: HR(max) measured during field tests can be underestimated in relation to that measured during competition activities, maybe because the tests represent an artificial situation for athletes, who do not feel as motivated as during competitions.