Interval versus constant-load exercise training in adults with Cystic Fibrosis.

BACKGROUND: The efficacy of interval exercise (IE) compared to constant-load exercise (CLE) training remains unsettled in adults with Cystic Fibrosis (CF). METHODS: Twenty-four adults with CF were randomised to 30-min IE (100 % peak work capacity (WRpeak) for 30-s alternated with 40 % WRpeak for 30-s; n = 12) or 30-min CLE (70 % WRpeak; n = 12) training, 3 times weekly, for 12 weeks. Isometric quadriceps muscle strength was assessed using a strain gauge Myometer. RESULTS: The magnitude of improvement in quadriceps muscle strength was greater (p = 0.037) in the IE (by 32 ±â€¯13 Nm) compared to the CLE (by 23 ±â€¯12 Nm) groups. Maximum inspiratory and expiratory mouth pressures were significantly improved only in the IE group (by 30 ±â€¯10 cmH2O; p = 0.009 and 13 ±â€¯4 cmH2O; p = 0.007, respectively). Arterial oxygen saturation during training was higher (p = 0.002) for IE (94 ±â€¯1%) compared to CLE (91 ±â€¯1%), whereas dyspnoea scores were lower (p = 0.001) for IE (3.8 ±â€¯0.7) compared to CLE (5.9 ±â€¯0.8) CONCLUSIONS: IE is superior to CLE in improving peripheral and respiratory muscle strength and preferable to CLE because it is associated with lower exercise-induced arterial oxygen desaturation and breathlessness.

Tuberculous pericarditis: three cases and brief review.

Tuberculous pericarditis is a form of extrapulmonary tuberculosis that is considered unusual in western coun-tries. Diagnosis is often challenging, while proper treatment has a major impact on prognosis. We present three interesting cases, with complicated or unusual manifestations of tuberculous pericarditis: a patient with cardiac tamponade as the initial manifestation of tuberculosis; a patient progressing to constriction despite adequate treatment; and a patient receiving anti-TNFalpha, who developed pericarditis in the context of immune reconstitution inflammatory syndrome. We briefly review the clinical features of tuberculous pericarditis, whilst our main focus is on the available diagnostic techniques and treatment aspects. In conclusion, tuberculous pericarditis remains an active thread in the western world. A high index of suspicion combined with the use of all available diagnostic techniques are important to increase diagnostic yield. Prompt and effective treatment is essential to reduce morbidity and mortality.

Efficacy of beclomethasone dipropionate HFA 200 microg once daily in chronic obstructive pulmonary disease and bronchial asthma.

The efficacy and safety of once-daily beclomethasone dipropionate (BDP; 200 microg), in combination with the propellant hydrofluoroalkane-134a (HFA) was compared with that of budesonide turbuhaler (BUD-TH) 400 microg twice daily and fluticasone propionate inhaler (FP-IH) 250 microg twice daily in 40 patients with bronchial asthma or chronic obstructive pulmonary disease. All patients had used inhaled corticosteroids for at least 1 month. On randomization, 20 patients were switched to HFA-BDP and 20 patients remained on their existing BUD-TH or FP-IH treatment. After 8 weeks, HFA-BDP demonstrated a greater improvement in spirometric values, respiratory symptoms and beta2-agonist use. No significant local adverse effects were observed. Blood cortisol levels remained in the normal range in both groups. We conclude that HFA-BDP (200 microg once-daily) offered more benefit in terms of clinical and spirometry indices than BUD-TH (400 microg twice daily) or FP-IH (250 microg twice daily) in patients with moderate asthma and chronic obstructive pulmonary disease.