Criterion-related validity of the short International Physical Activity Questionnaire against exercise capacity in young adults.

BACKGROUND: Self-reported physical activity (PA) is well associated with cardiorespiratory fitness and exercise capacity. The short International Physical Activity Questionnaire (IPAQ-short) is a frequently used instrument for cross-national assessments of PA in adults. The purpose of this study was to validate IPAQ-short against exercise capacity in Greek young adults. DESIGN AND METHODS: One hundred and thirteen men and 105 women, aged 20-29 years, were randomly selected from a larger population of young health-science students. A Greek version of IPAQ-short (IPAQ-Gr) was administered to all participants before their exercise capacity evaluation with a maximal Bruce treadmill test. Multiple regression and correlation analyses were used to examine the associations between all IPAQ-Gr outcomes with exercise capacity based on maximal treadmill time. RESULTS: Spearman's correlations for total and vigorous PA against maximal treadmill time were significant in all groups examined, ranging from 0.35 to 0.43. Moderate and walking PA correlations were poor and nonsignificant, ranging from near-zero values to 0.19. In multiple linear regression analysis, only sex, smoking, and vigorous PA from all personal and log-transformed IPAQ-Gr data were significantly associated with maximal treadmill time. Partial correlation analysis for the overall population, adjusted for sex and smoking, showed that total PA (r=0.37) and vigorous PA (r=0.47) were significantly associated with exercise capacity. CONCLUSION: IPAQ-Gr was tested against exercise capacity and showed acceptable validity properties in Greek young adults. Total and vigorous weekly PA expenditure were well associated with exercise capacity, presenting significant validity correlations against maximal treadmill time.

Myocardial inflammation in Duchenne Muscular Dystrophy as a precipitating factor for heart failure: a prospective study.

BACKGROUND: In patients with Duchenne Muscular Dystrophy (DMD), the absent or diminished dystrophin leads to progressive skeletal muscle and heart failure. We evaluated the role of myocardial inflammation as a precipitating factor in the development of heart failure in DMD. METHODS: 20 DMD patients (aged 15-18 yrs) and 20 age-matched healthy volunteers were studied and followed-up for 2 years. Evaluation of myocarditis with cardiovascular magnetic resonance imaging (CMR) was performed using STIR T2-weighted (T2W), T1-weighted (T1W) before and after contrast media and late enhanced images (LGE). Left ventricular volumes and ejection fraction were also calculated. Myocardial biopsy was performed in patients with positive CMR and immunohistologic and polymerase chain reaction (PCR) analysis was employed. RESULTS: In DMD patients, left ventricular end-diastolic volume (LVEDV) was not different compared to controls. Left ventricular end-systolic volume (LVESV) was higher (45.1 +/- 6.6 vs. 37.3 +/- 3.8 ml, p < 0.001) and left ventricular ejection fraction (LVEF) was lower (53.9 +/- 2.1 vs. 63 +/- 2.4%, p < 0.001). T2 heart/skeletal muscle ratio and early T1 ratio values in DMD patients presented no difference compared to controls. LGE areas were identified in six DMD patients. In four of them with CMR evidence of myocarditis, myocardial biopsy was performed. Active myocarditis was identified in one and healing myocarditis in three using immunohistology. All six patients with CMR evidence of myocarditis had a rapid deterioration of left ventricular function during the next year. CONCLUSIONS: DMD patients with myocardial inflammation documented by CMR had a rigorous progression to heart failure.

Stabilization of human urine doping control samples: IV. Human chorionic gonadotropin.

The presence of proteolytic enzymes in urine samples, coming from exogenous or endogenous sources, enhances the cleavage of human chorionic gonadotropin (hCG). Moreover, elevated temperatures occurring occasionally during the delayed transportation of sport urine samples, favor the nicking of the hCG molecule. The aim of the current study, funded by the World Anti-Doping Agency (WADA), was the application of a stabilization mixture in athletes' urine samples to chemically inactivate proteolytic enzymes coming from exogenous or endogenous sources so as to prevent the degradation of hCG. The stabilization mixture applied, already tested for the stabilization of endogenous steroids and recombinant erythropoietin (rEPO), was a combination of antibiotics, antimycotic substances, and protease inhibitors. Incubation experiments were conducted in the presence or absence of the stabilization mixture in urine aliquots spiked with six proteases (first series of experiments) and one microorganism associated with urinary tract infections (UTI) (second series of experiments). Intact hCG levels were evaluated by using the EIAgen Total hCG kit. In the first series of experiments, hCG levels were reduced in the untreated aliquots following incubation at 37 degrees C. The addition of the chemical stabilization mixture prevented degradation of hCG induced by four of the proteases applied. In the second series of experiments, no significant difference was found in urine inoculated with E. coli, between aliquots treated with chemical mixture and the untreated aliquots. The addition of the proposed chemical stabilization mixture improves the quality of athletes' urine samples against possible deterioration due to high temperatures or attempts of proteolytic manipulation.

Association of high blood pressure with body mass index, smoking and physical activity in healthy young adults.

INTRODUCTION: The purpose of this study was to examine the associations between resting blood pressure (BP), smoking, physical activity (PA) and body mass index (BMI) in Greek young adults. MATERIALS AND METHODOLOGY: A standardised questionnaire and the Greek version of IPAQ-short were given to 1500 randomly selected health science students, in order to record smoking behaviour, PA status, BMI and resting BP. All healthy young adults aged 19-30 years old were eligible. The final size of the study cohort was 1249 students (522 men). RESULTS: Males' BP was 129.2/77.0 mmHg, significantly higher than the females' values of 119.9/73.4 mmHg. Approximately 17% of the total population were classified as overweight and 3% as obese. In the overall population, smoking prevalence was 35.2%, with 15.3% being heavy smokers (≥21 cigs/d). Smoking prevalence did not differ significantly between sexes. The prevalence of health-enhancing PA (high PAclass) was only 14.0%, while 42.8% of the study population were classified as insufficiently active (low PAclass). Of the three lifestyle risk factors examined, only BMI was significantly and directly associated with systolic and diastolic BP levels. The prevalence of hypertension (≥140/90 mmHg) was significantly higher in men compared to women, and in obese and overweight participants compared to normal-weight subjects. Smoking and categorical PA (PAclass) were not correlated with BP. Continuous vigorous PAscore was significantly and directly associated with systolic BP, but only in males. CONCLUSION: BMI was significantly and directly associated with resting BP in both sexes. Smoking prevalence and PA status were not associated with BP in this sample of Greek young adults.

Q fever in children in Greece.

The aim of this study was to investigate the incidence, epidemiology, and clinical manifestations of Q fever among hospitalized children in Greece. During a two-year period, 1,200 children with various clinical manifestations were prospectively tested for Coxiella burnetii infection by indirect immunofluorescence. Acute Q fever was diagnosed in eight (0.67%) patients. No chronic case of infection was detected. Multivariate analysis showed that children 11-14 years old and children reporting consumption of cheese from rural areas were at increased risk for this illness. Clinical manifestations of acute Q fever were pneumonia (two patients), meningitis (two), prolonged fever (two), hepatitis (one), and hemolytic-uremic syndrome (one). Q fever accounted for 2.9% of the cases with prolonged fever, 1.2% of the cases of meningitis, and 0.5% of the cases of pneumonia. Fever and headache were the most common symptoms at presentation. Our study indicates that Q fever is a rare cause of hospitalization during childhood.

Effects of smoking on heart rate at rest and during exercise, and on heart rate recovery, in young adults.

INTRODUCTION: There is an established link between smoking, abnormal heart rate (HR) values, and impaired cardiovascular health in middle-aged or older populations. The purpose of this study was to examine the effects of smoking on resting HR and on HR responses during and after exercise in young adults. METHODS: A sample of 298 young adults (159 men), aged 20-29 years old, were selected from a large population of health-science students based on health status, body mass index, physical activity, and smoking habit. All subjects underwent a maximal Bruce treadmill test and their HR was recorded during, at peak, and after termination of exercise. RESULTS: Smokers had significantly higher resting HR values than non-smokers. Both female and male smokers showed a significantly slower HR increase during exercise. Female smokers failed to reach their age-predicted maximum HR by 6.0 bpm and males by 3.6 bpm. The actual maximum HR achieved (HRmax) was significantly lower for both female smokers (191.0 bpm vs.198.0 bpm) and male smokers (193.2 bpm vs.199.3 bpm), compared to non-smokers. Heart rate reserve was also significantly lower in female (114.6 bpm vs. 128.1 bpm) and male smokers (120.4 bpm vs. 133.0 bpm). During recovery, the HR decline was significantly attenuated, but only in female smokers. Females had a higher resting HR and showed a higher HR response during sub-maximal exercise compared to males. CONCLUSIONS: Smoking was found to affect young smokers' HR, increasing HR at rest, slowing HR increase during exercise and impairing their ability to reach the age-predicted HRmax. In addition, smoking was associated with an attenuated HR decline during recovery, but only in females.

Relationship of home blood pressure with target-organ damage in children and adolescents.

The objective of this study was to compare home blood pressure (HBP) vs. ambulatory (ABP) and clinic (CBP) measurements in terms of their association with target-organ damage in children and adolescents. A total of 81 children and adolescents (mean age 13 ± 3 years, 53 boys) referred for elevated CBP had measurements of CBP (1 visit), HBP (6 days) and ABP (24-h). Seventy-six participants were also assessed with carotid-femoral pulse wave velocity (PWV) and 54 with echocardiography. Average CBP was 122.1 ± 15.1/71 ± 12.9 mm Hg (systolic/diastolic), HBP 121.3 ± 11.5/69.4 ± 6.6 mm Hg and 24-h ABP 118.9 ± 12/66.6 ± 6.1 mm Hg. Left ventricular mass (LVM) was correlated with systolic blood pressure (BP) (coefficient r = 0.55/0.54/0.45 for 24-h/daytime/nighttime ABP, 0.53 for HBP and 0.41 for CBP; all P< 0.01). No significant correlations were found for diastolic BP. PWV was also significantly correlated with systolic BP (r = 0.52/0.50/0.48 for 24-h/daytime/nighttime ABP, 0.50 for HBP and 0.47 for CBP; all P < 0.01). Only diastolic ABP and HBP were significantly correlated with PWV (r = 0.30 and 0.28, respectively, P<0.05). In multivariate stepwise regression analysis (with age, gender, body mass index [BMI], clinic, home and 24-h ambulatory systolic/diastolic BP and pulse pressure, clinic, home and 24-h heart rate as independent variables), PWV was best predicted by systolic HBP (R(2) = 0.22, beta ± s.e. = 0.06 ± 0.01), whereas LVM was determined (R(2) = 0.67) by 24-h pulse pressure (beta = 1.21 ± 0.41), age (beta = 2.93 ± 1.32), 24-h heart rate (beta = -1.27 ± 0.41) and BMI (beta = 1.78 ± 0.70). These data suggest that, in children and adolescents, ABP as well as HBP measurements appear to be superior to the conventional CBP measurements in predicting the presence of subclinical end-organ damage.

Reliability measures of the short International Physical Activity Questionnaire (IPAQ) in Greek young adults.

INTRODUCTION: The short International Physical Activity Questionnaire (IPAQ-short) has frequently been used for national and international comparable physical activity (PA) prevalence studies. The purpose of this paper is to describe a Greek version of IPAQ-short (IPAQ-Gr) and present its reliability properties in Greek young and healthy adults. METHODS: Two hundred and eighteen health science students of the Athens Technological Educational Institute, aged 19-29 years, were randomly selected and participated in the study. An intra-examiner reliability study over time (8 and 30 days apart) was carried out to assess IPAQ-Gr repeatability. An inter-examiner reliability study was also performed to assess the consistency of IPAQ-Gr outcomes between examiners. At the same time, an intra-examiner reliability study using an independent sample of 175 medical students at the University of Ioannina was carried out in order to examine multi-centre IPAQ-Gr reliability. Intra-class correlation coefficients for IPAQ scores and kappa statistics and percent agreement for physical activity classification were used in the analysis. RESULTS: Intra-class correlation coefficients (ICCs) between day-1 and day-9 assessments for IPAQ total and vigorous PA were high in all groups examined (0.84 to 0.93). ICCs for walking PA, moderate PA and sitting hours were lower, but still good (0.69 to 0.81). Repeatability of IPAQ-Gr outcomes after one-month re-administration was high for total and vigorous PA (0.87, 0.81) and good for moderate (0.66) and walking PA (0.75). Inter-examiner reliability data showed that all correlations between examiners were greater than 0.70, up to 0.87 (paired t-test, p=NS), with the exception of moderate PA, where correlations were weaker (0.58 to 0.64). Similar results were found when intra-examiner correlations were compared between educational institutes (multi-centre inter-examiner reliability of IPAQ). CONCLUSIONS: IPAQ-Gr was found to present acceptable reliability properties in Greek young adults. IPAQ-Gr showed high repeatability values for total and vigorous PA, and good for moderate and walking PA.

Effects of chronic smoking on exercise tolerance and on heart rate-systolic blood pressure product in young healthy adults.

BACKGROUND: Smoking is a major cause of cardiovascular disease and mortality. Smoking-related deaths in Greece account for 23%, whereas 41% of young Greeks are smokers, the highest percentage in Europe. The purpose of this study was to examine the effects of chronic smoking on the rate-pressure product and exercise tolerance in young, healthy male smokers. DESIGN AND METHODS: Forty-two smokers and 51 nonsmokers were selected from a population of 543 students based on their age, sex, body mass index, physical fitness, smoking habit and health status. All participants were tested with the standard Bruce treadmill protocol. The rate-pressure product was obtained at rest and during exercise at a given submaximal workload. The evaluation of exercise tolerance was based on peak workload achieved and maximal exercise test duration. RESULTS: The smokers had a higher rate-pressure product at rest (P<0.001) due to their higher resting heart rate (P<0.001). Resting values of blood pressure did not differ significantly between the two groups. During exercise, smokers had a greater rate-pressure product (P<0.001), mainly due to their significantly higher systolic blood pressure (P=0.008). The smokers had a higher submaximal heart rate (P=0.005), but the differences in heart rate between groups were reduced for smokers during exercise when compared to rest. The smokers' exercise tolerance was impaired and their maximal exercise test duration time was significantly shorter (P<0.001). CONCLUSIONS: Chronic smoking was found to affect young male smokers' cardiovascular fitness, impairing the economy and decreasing the capacity of their circulatory system.