Jogging-induced spontaneous peri-renal hemorrhage: a rare urologic emergency

Spontaneous peri-renal hemorrhage (SPH), also known as Wünderlich's syndrome, is an uncommon and rare urologic emergency, which could become life-threatening, requiring immediate diagnosis and management. The diagnosis can be challenging, even with new imaging modalities, and management can vary from conservative approach, to surgical intervention. We present a case of jogging-induced SPH diagnosed using CT scan that was managed conservatively, with follow-up for up to five years using CT imaging studies.

Standardized loads acting in knee implants

The loads acting in knee joints must be known for improving joint replacement, surgical procedures, physiotherapy, biomechanical computer simulations, and to advise patients with osteoarthritis or fractures about what activities to avoid. Such data would also allow verification of test standards for knee implants. This work analyzes data from 8 subjects with instrumented knee implants, which allowed measuring the contact forces and moments acting in the joint. The implants were powered inductively and the loads transmitted at radio frequency. The time courses of forces and moments during walking, stair climbing, and 6 more activities were averaged for subjects with I) average body weight and average load levels and II) high body weight and high load levels. During all investigated activities except jogging, the high force levels reached 3,372–4,218N. During slow jogging, they were up to 5,165N. The peak torque around the implant stem during walking was 10.5 Nm, which was higher than during all other activities including jogging. The transverse forces and the moments varied greatly between the subjects, especially during non-cyclic activities. The high load levels measured were mostly above those defined in the wear test ISO 14243. The loads defined in the ISO test standard should be adapted to the levels reported here. The new data will allow realistic investigations and improvements of joint replacement, surgical procedures for tendon repair, treatment of fractures, and others. Computer models of the load conditions in the lower extremities will become more realistic if the new data is used as a gold standard. However, due to the extreme individual variations of some load components, even the reported average load profiles can most likely not explain every failure of an implant or a surgical procedure.

[Effects of aquatic physical exercise on the kinematic gait pattern in patients with Parkinson's disease: a pilot study]

AIM. To determine the effects of an aquatic-based physical exercise program on gait parameters of patients with Parkinson's disease (PD). PATIENTS AND METHODS. A total of nine patients diagnosed with idiopathic PD (stages I-III according to the Hoehn and Yahr scale) carried out an aquatic physical exercise program which lasted for five months, with one session per week. A three-dimensional biomechanical analysis was used to determine the effects of the program on several kinematic variables (walking speed, cadence, stride length, step time, single and double support time, angles of the hip, knee and ankle joints) which were assessed by a treadmill-walking test. RESULTS. At the end of the program, significant improvement in walking speed, stride length and on the relationship between single and double support time (p < 0,05). Although improvements in all tested ranges of motion were obtained, these did not reach statistical significance. CONCLUSIONS. Aquatic-based physical exercise seems to have positive effects in some aspects of the gait kinematics parameters present in the typical gait pattern of patients with PD.

Different physical activity subtypes and risk of metabolic syndrome in middle-aged and older Chinese people

BACKGROUND

The prevalence of metabolic syndrome (MetS) is growing rapidly in China. Tai chi and dancing are common types of exercise among middle-aged and elderly Chinese. It remains unclear whether these activities are associated with a lower risk of MetS.

METHODOLOGY/PRINCIPAL FINDINGS

A total of 15,514 individuals (6,952 men, 8,562 women) aged 50 to 70 years from the Dongfeng-Tongji Cohort in Shiyan, China participated in a cross-sectional study. Physical activity and other lifestyle factors were assessed with semi-structured questionnaires during face-to-face interviews. MetS was defined by the current National Cholesterol Education Program/Adult treatment Panel III criteria for Asian Americans. The prevalence of MetS was 33.2% in the study population. In the multivariable-adjusted logistic regression analyses, total physical activity levels were monotonically associated with a lower odds of MetS [OR 0.75 comparing extreme quintiles, 95% confidence interval (CI) 0.66-0.86, P<0.001]. Compared with non-exercisers in a specific exercise type, jogging (OR 0.82, 95% CI 0.68-1.00, P = 0.046), tai chi (OR 0.72, 95% CI 0.60-0.88, P<0.001), and dancing (OR 0.56, 95% CI 0.47-0.67, P<0.001) were associated with significantly lower odds of MetS. Furthermore, each 1-h/week increment in tai chi and dancing was associated with a 5% (95% CI 2%-9%) and a 9% (95% CI 6%, 12%) lower risk of MetS.

CONCLUSIONS/SIGNIFICANCE

Jogging, tai chi and dancing are associated with a significantly lower risk of having MetS in middle-aged and older Chinese. Future intervention studies should consider the role of jogging, tai chi and dancing in preventing MetS.

Influence of Carbohydrate Ingestion on Oxidative Stress and Plasma Antioxidant Potential Following a 3 h Run

Concentrations of reactive oxygen species (ROS) increase during exercise secondary to increased oxygen uptake, xanthine oxidase activity, and immune system activation. Carbohydrate compared to placebo beverage ingestion is associated with an attenuated cortisol and catecholamine response. Catecholamines can undergo autooxidation to form ROS. We hypothesized that during intense exercise, ingestion of carbohydrate compared to placebo would diminish oxidative stress. Sixteen experienced marathoners ran on treadmills for 3 h at approximately 70% VO2(max) on two occasions while receiving carbohydrate or placebo beverages (11/h, double-blinded) in a randomized, counterbalanced order. Blood samples were collected before and immediately after exercise, snap frozen in liquid nitrogen, and stored at -80 degrees C until analysis. Plasma samples were analyzed for F2-isoprostanes (FIP) and lipid hydroperoxides (ROOH) as measures for lipid peroxidation, ferric reducing ability of plasma (FRAP) as a measure of plasma antioxidant potential and for cortisol. The pattern of change in cortisol was significantly different between carbohydrate and placebo conditions (P = 0.024), with post-exercise levels higher in the placebo condition. Under both carbohydrate and placebo conditions, significant increases in FIP, ROOH, and FRAP were measured, but the pattern of increase was not different (FIP, interaction effect, P = 0.472; ROOH, P = 0.572; FRAP, P = 0.668). Despite an attenuation in the cortisol response, carbohydrate compared to placebo ingestion does not counter the increase in oxidative stress or modulate plasma antioxidant potential in athletes running 3 h at 70% VO2(max).

[Physical exercise and intraocular pressure]

In the 1960s, it had been observed that physical exercises could reduce the intraocular pressure (IOP) in patients with glaucoma. However, the effect of IOP reduction varied with exercise type and intensity, as well as the duration after exercise. Difference of lowering the IOP in glaucoma patients and healthy people were also observed. The mechanisms of reducing the IOP by exercise were very complicated and believed to be associated with the lower concentration of norepinephrine, the rising of colloid osmotic pressure, the co-action of nitric oxide and endothelin after exercise, and also related to the gene polymorphism of β2-adrenergic receptor. Physical exercise, such as jogging, walking and bicycle riding, could be suggested as a complimentary therapy in addition to the pharmaceutical and surgical therapies available for glaucoma patients, even though the mechanism for lowering IOP is not clear enough.

The effectiveness of healthy physical fitness programs on people with intellectual disabilities living in a disability institution: six-month short-term effect

Little information is available on the provision of physical fitness and intervention program among people with intellectual disabilities. The aim of this study is to provide information of examining the effectiveness of healthy physical fitness programs on people with intellectual disabilities living in a disability institution. There were 146 participants with intellectual disabilities (age 19-67 years) were recruited in the study. We collected information on disability condition (type and level), height, weight, BMI, and physical fitness status (includes V-shape sit and reach test, sit-up 30s, sit-up 60s, and shuttle run) at the beginning and 6 months later of the program intervention. The results show that there were statistical decreases in individual's weight, BMI score, BMI category, and positive improvement in V-shape sit and reach test, sit-up in 30s and 60s tests after 6-month interventions. However, the shuttle run test did not improve at the post-test among people with intellectual disabilities. The results also showed that the mild disability level group has the highest effectiveness on the healthy fitness program on decreasing body weight. Generally speaking, the preliminary study found the healthy exercise program has positive fitness effects on people with intellectual disabilities. To maximize the benefits of regular physical activity on people with ID, there is a need to evaluate the long-term effect of the intervention program and then to initiate the healthy exercise strategies in institution for this group of people.

Midpoint-based empirical decomposition for nonlinear trend estimation

This paper presents a new method for nonlinear trend estimation of non-stationary signals, by which the trend can be self-adaptively decomposed through calculating the midpoint-based local means. In this method, the so-called midpoints are proposed to construct the local mean of a signal instead of two envelopes in the classical empirical mode decomposition (EMD) algorithm, thus resulting in the midpoint-based empirical decomposition. Furthermore, a negentropy-based statistical method is presented to justify decomposition of the trend. Simulation results indicate that the new algorithm improves the performance of signal decomposition and trend estimation in comparison with the classical EMD algorithm. The proposed method also shows the value in self-adaptively estimating the nonlinear respiratory component from non-invasively measured ventilation signals.

[Exercise-induced anaphylaxis]

Exercise-induced anaphylaxis (EIA) was defined for the first time in 1980. EIA is associated with different kind of exercise, although jogging is the most frequently reported. The clinical manifestations progress from itching, erythema and urticaria to some combination of cutaneous angioedema, gastrointestinal and laryngeal symptoms and signs of angioedema and vascular collapse. Mast cell participation in the pathogenesis of this syndrome has been proved by the finding of an elevated serum histamine level during experimentally-induced attacks and by cutaneous degranulation of mast cells with elevated serum tryptase after attacks. As predisposing factors of EIA, a specific or even aspecific sensitivity to food has been reported and such cases are called "food-dependent EIA". Many foods are implicated but particularly wheat, vegetables, crustacean. Another precipitating factor includes drugs intake (non steroidal anti-inflammatory drugs), climate variations and menstrual cycle factors. Treatment of an attack should include all the manoeuvres efficacious in the management of conventional anaphylactic syndrome, including the administration of epinephrine and antihistamines. Prevention of the attacks may be achieved with the interruption of the exercise at the appearance of the first premonitory symptoms. To prevent the onset of EIA it is also suitable to delay the exercise practice after at least 4-6 hours from the swallowing of food.

Characteristics of urban sidewalks/streets and objectively measured physical activity

Several studies have found significant relationships between environmental characteristics (e.g., number of destinations, aesthetics) and physical activity. While a few of these studies verified that the physical activities assessed were performed in the environments examined, none have done this in an urban, neighborhood setting. This information will help efforts to inform policy decisions regarding the design of more "physically active" communities. Fourteen environmental characteristics of 60, 305-m-long segments, located in an urban, residential setting, were directly measured using standardized procedures. The number of individuals walking, jogging, and biking in the segments was assessed using an observation technique. The segments were heterogeneous with regards to several of the environmental characteristics. A total of 473 individuals were seen walking, bicycling, or jogging in the segments during 3,600 min of observation (60 min/segment). Of the 473 seen, 315 were walking, 116 bicycling, and 42 jogging. A greater number of individuals were seen walking in segments with more traffic, sidewalk defects, graffiti, and litter and less desirable property aesthetics. Only one environmental characteristic was associated with bicycling and none were significantly related with jogging. This study provides further evidence that environmental characteristics and walking are related. It also adds new information regarding the importance of scale (e.g., micro, macro) and how some environmental characteristics of urban, residential sidewalks and streets relate to physical activity.

[Blood pressure lowering through physical training--what can be achieved?]

In the meantime, the positive effect of physical training, both in primary and secondary prevention of hypertension, has been confirmed in numerous studies. In recent years, it has been shown that regular sports activity of moderate intensity suffices to bring about a lowering of blood pressure. Highly recommended forms of training include walking, jogging, cycling and dynamic power training. Over a period of three to four months,a gradual increase in activity--for example, a daily training period of 15 to 20 minutes--should be the aim. However, an intensification of general physical activities may also lower blood pressure, irrespective of other risk factors.

Effect of regular Tai Chi and jogging exercise on neuromuscular reaction in older people

OBJECTIVES

to investigate the effects of regular Tai Chi (TC) or jogging exercise on neuromuscular reaction in older people.

DESIGN

cross-sectional study.

SETTING

university biomechanics laboratory.

SUBJECTS

21 long-term elderly TC practitioners were compared with 18 regular elderly joggers and 22 sedentary counterparts.

MEASUREMENTS

electromyography (EMG) was used to detect the neuromuscular reaction of the leg muscles to an unexpected ankle inversion perturbation. The latency of the muscles, which was defined as the time that the moment of perturbation began to the onset of the EMG response, was evaluated.

RESULTS

a one-way ANOVA revealed that there were significant differences in the latency of the rectus femoris (R) and anterior tibialis (T) muscles between the three groups, but that there were no differences in the latency of the semitendinosus (S) and gastrocnemius (G) muscles. Further tests indicated that the R and T muscles in the TC and jogging groups were activated significantly faster than those in the control group. No significant difference was found for the muscle onset latencies between the TC and jogging groups.

CONCLUSION

maintaining information processing speed during ageing is important, because of the role that it plays in many everyday events. The R and T muscles in the regular TC and jogging groups showed faster responses to unexpected ankle inversion perturbations, which is helpful for the timely correction of postural disturbances, than those in the sedentary control group.

Endurance Exercise Training in Orthostatic Intolerance

Orthostatic intolerance is a syndrome characterized by chronic orthostatic symptoms of light-headedness, fatigue, nausea, orthostatic tachycardia, and aggravated norepinephrine levels while standing. The aim of this study was to assess the protective effect of exercise endurance training on orthostatic symptoms and to examine its usefulness in the treatment of orthostatic intolerance. 2768 military recruits were screened for orthostatic intolerance by questionnaire. Tilt-table testing identified 36 cases of orthostatic intolerance out of the 2768 soldiers. Subsequently, 31 of these subjects with orthostatic intolerance entered a randomized, controlled trial. The patients were allocated randomly to either a “training” (3 months jogging) or a “control” group. The influence of exercise training on orthostatic intolerance was assessed by determination of questionnaire scores and tilt-table testing before and after intervention. After training, only 6 individuals of 16 still had orthostatic intolerance compared with 10 of 11 in the control group. The Fisher exact test showed a highly significant difference in diagnosis between the 2 groups ( P =0.008) at the end of the study. Analysis of the questionnaire-score showed significant interaction between time and group ( P =0.001). The trained subjects showed an improvement in the average symptom score from 1.79±0.4 to 1.04±0.4, whereas the control subjects showed no significant change in average symptom score (2.09±0.6 and 2.14±0.5, respectively). Our data demonstrate that endurance exercise training leads to an improvement of symptoms in the majority of patients with orthostatic intolerance. Therefore, we suggest that endurance training should be considered in the treatment of orthostatic intolerance patients.

Lower airway inflammatory responses to high-intensity training in athletes

PURPOSE

There is an increased prevalence of asthma and airway hyperresponsiveness in elite athletes, particularly in swimmers. High intensity exercise may induce airway inflammation and subsequent remodelling in these subjects. Our aim was to evaluate the effects of high-intensity training on induced-sputum cell populations in elite athletes.

METHODS

Swimmers and runners with hyperresponsive airways (SH and RH), defined by a provocative concentration of methacholine inducing a 20% decrease in FEV1 (PC20) <16 mg/ml or with normoresponsive airways (PC20 > 16 mg/ml; SN, RN) to methacholine were enrolled. The mean PC20 was 2.27 mg/ml in SH (n=12), 32.2 in SN (n=10), 3.25 in RH (n=10) and 41.5 in RN (n=13). All athletes had two induced sputum analyses at one- to two-week intervals in random order: after a period of 72 hours without training, 24 hours after a training session.

RESULTS

PC20 was unchanged after training. The median % neutrophils and eosinophils in groups SH, SN, RH, and RN, respectively, were 26.5-1.6, 8.6-0.3, 28.0-0.03 and 25.5-0.1 before and 45.0-0.5, 31.1-0.4, 54.0-0.6 and 48.3-0.3 after training. While the magnitude of the increase in neutrophils was similar for all groups, it reached statistical significance (pre-post-training) only in the SH group (P = 0.039).

CONCLUSION

A one-hour session of high-intensity training was associated with an increase in airway neutrophils among hyperresponsive swimmer athletes, while airway responsiveness remained unchanged in all groups.

Combined endurance/resistance training reduces NT-proBNP levels in patients with chronic heart failure

AIMS

This study was designed to evaluate the effects of combined endurance/resistance training on NT-proBNP levels in patients with chronic heart failure (CHF). The safety of resistive weight training for patients with CHF is questioned. Possible detrimental effects include an increase in ventricular diastolic pressure and secondary unfavourable remodelling. Circulating levels of the N-terminal fragment of brain natriuretic peptide (NT-proBNP) reflect left ventricular diastolic wall stress and are strongly related to mortality and treatment success in CHF.

METHODS AND RESULTS

In this study, 27 consecutive patients with stable CHF and left ventricular ejection fraction (LVEF) <35% were enrolled in a 4 months non-randomized combined endurance/resistance training programme. Blood sampling for measurement of NT-proBNP, functional assessment, cardiopulmonary exercise testing, echocardiography and radionuclide angiography were performed at entry and after 4 months. After 4 months, exercise training caused a significant reduction in circulating concentrations of NT-proBNP (2124+/-397 pg/ml before, 1635+/-304 pg/ml after training, p=0.046, interaction), whereas no changes were observed in an untrained heart failure control group. NYHA functional class (p=0.02, interaction), maximal (peak VO2: p=0.035, interaction; maximal workload: p<0.00001, interaction) and submaximal (workload at anaerobic threshold: p=0.001, interaction; rate-pressure product at anaerobic threshold: p=0.001, interaction) exercise parameters as well as work efficiency (Wattmax/VO2peak: p=0.0001, interaction) were significantly improved. In addition, a decrease in left ventricular end-systolic diameter was observed in the trained heart failure group (p=0.016).

CONCLUSION

Four months of combined endurance/resistance training significantly reduced circulating levels of NT-proBNP in patients with CHF, without evidence of adverse remodelling. Exercise training might offer additional non-pharmacological modulation of the activated neurohormonal pathways in the setting of CHF.

Construct validity of self-reported historical physical activity

The purpose of this study was to determine the construct-related validity of self-reported historical walking, running, and jogging (WRJ) activity on the basis of data from the Aerobics Center Longitudinal Study (Dallas, Texas). A total of 4,100 men and 963 women underwent at least one medical examination between 1976 and 1985 and completed a follow-up questionnaire in 1986. Levels of glucose, cholesterol, and triglycerides, resting systolic blood pressure, body mass index (weight (kg)/height (m)(2)), and cardiorespiratory fitness were measured at the time of the medical examination. The follow-up questionnaire assessed WRJ and other strenuous activities for each year from 1976 through 1985. Data analysis included Spearman and partial correlations, analysis of variance, analysis of covariance, and t tests. Results indicated significant correlations between recalled WRJ and treadmill times for each year throughout the 10-year period (r = 0.40-0.61). Participants were classified as historically either sufficiently physically active to receive a health benefit or insufficiently active for a health benefit. Engaging in sufficient levels of historical WRJ was associated with higher treadmill times and lower body mass indices for men and women and lower triglyceride levels for men. Self-reported historical WRJ can be assessed with reasonable validity in comparison with measured treadmill performance, with no decay in accuracy of reporting for up to 10 years in the past.

[The role of jogging in the prevention and treatment of cardiovascular disease]

Lack of exercise and poor eating habits are considered to be major causes of most diseases of civilization. In consequence, endurance sports, but also an integration of physical activity in everyday life, are gaining in importance. Positive effects of regular physical exercise have been described for CAD, arterial hypertension, lipid metabolic disorders, type 2 diabetes mellitus and the metabolic syndrome. In order to achieve an optimal training effect, exercise intensity should be oriented to the individual anaerobic threshold. As a rule of thumb, 30 minutes of endurance training--ideallyevery day--is considered necessary. Prior testing of a person's ability to undertake such activities should include ECG and blood pressure measurements, spirometry and lactate determination, and contraindications must be taken into account.

Health benefits associated with exercise habituation in older Japanese men

BACKGROUND AND AIMS

The purpose of this study was to compare the effects of exercise habituation (3-32 years, mean 13.2 years) on physical vitality among five different groups.

METHODS

One hundred and two independent, community-dwelling elderly Japanese men, aged 64.6 +/- 6.6 years, were recruited as subjects. The vital age test battery consisted of various coronary heart disease risk factors and physical fitness elements.

RESULTS

The results of analysis of variance revealed that vital age as an index of physical vitality was youngest in joggers (47.9 yr, N=18), intermediate in trekkers (55.8 yr, N=20) and walkers (59.1 yr, N=18), and oldest (69.6 yr, N=20) in patients with ischemic heart disease (IHD). The difference between chronological age and vital age was approximately 15 years (p<0.05) in joggers, and 8 years (p<0.05) in trekkers and walkers. The vital age of sedentary persons (N=26) was only 1.9 years (NS) younger than their chronological age, which was similar to the difference (vital age of 64.1 +/- 8.5 yr vs chronological age of 65.7 +/- 5.4 yr) previously observed in similarly aged exercising IHD patients.

CONCLUSIONS

These results indicate that exercise habituation significantly affects the overall health status of most individuals, irrespective of mode of exercise. Among the three modes of exercise, jogging may be most beneficial. Furthermore, regularly exercising coronary patients may have physical vitality similar to that of sedentary men.

Jogging support system with portable monitoring device and health manage software

At MEDINFO 2001 we reported about an ambulatory biosignal memory device. As an application of this system, we have developed a portable jogging monitoring device and studied its application for health management here. This device is a micro processor based system with some sensors necessary to monitor condition of the user during jogging, that is, a heart rate sensor, a GPS sensor and a physical activity sensor. We also have developed PC based health management software that receives jogging data after jogging and stores it as a long term jogging trend data. From these long term data it feeds back the distance completion of jogging on the virtual course. Moreover it can show the trend of jogging time, distance, average heart rate and the user can know his/her own health condition.