摘要:

The purpose of this study was to assess the applicability of simulated work activity (SWA) in the clinical setting with a suggested pragmatic protocol that can be safely and widely employed. The patients underwent SWA if ≥ 7 metabolic equivalents (METS) were achieved on symptom limited graded exercise testing (SLGXT). Protocols of weight carrying (WCT) 20–50 lb at 1.5–2 mph for 3 minutes, and repetitive weight lifting (WLT) 30–45 lb for 4 minutes were utilized. Fifteen men completed the study 12 ± 9 months after the cardiac event. Three had had myocardial infarction (MI), 1 percutaneous transluminal coronary angioplasty (PTCA), 1 coronary artery bypass surgery (CABG), 5 MI and PTCA, 4 MI and CABG, and 1 MI, PTCA, and CABG. Medication regimens remained the same through the study period. Hemodynamic variables at maximum rate of perceived exertion (RPE) of WCT (12.5 ± 3.0) and WLT (12.1 ± 3.1) were compared with comparable RPE of SLGXT (12.7 ± 0.6). At this mean RPE value the HR in the WCT of 102 ± 13 bpm was significantly lower than 119 ± 18 bpm in the SLGXT (P < 0.01) and 116 ± 16 bpm in the WLT (P < 0.01). SBP of 134 ± 24 mmHg in the WLT was significantly lower than 149 ± 21 mmHg in the SLGXT (P < 0.05) and 151 ± 13 mmHg in the WCT (P < 0.05). DBP 92 ± 8 mmHg in the WCT was significantly higher than 81 ± 11 mmHg in SLGXT (P<0.01) and 79 ± 11 mmHg in WLT (P < 0.01). All tests were completed without complications. In conclusion, a clinical protocol for SWA for selected patients after various cardiac events has been demonstrated to provide specific weight carrying and weight lifting limits. Exercise prescription derived from SLGXT and from RPE alone cannot be safely applied to weight carrying and lifting activity. Further studies are needed to assess the impact of these tests on return to physical labor type work.

ISSN:0883-9212    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The temporal relationship between cocaine use and myocardial infarction is well documented. Several mechanisms have been proposed to explain this relationship. An increase in double product as a result of cocaine use seems logical but should not be a problem in patients who have normal coronary arteries. Coronary spasm has also been invoked but has not been duplicated in the catheterization laboratory using ergonovine. Coronary thrombi are found in many but not all of the patients. Furthermore, the role of cocaine in coronary thrombus formation has not been clarified. Clearly there is a need for more studies.

ISSN:0883-9212    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Validity and reliability of a short physical activity history were assessed in two studies. Validity was studied in 2766 women and 2303 men, participants in CARDIA, a biracial study. Ages ranged from 18 to 30 years. The activities performed in the past 12 months by ≥ 50 per cent of participants were walking/hiking, nonstrenuous sports, shoveling/lifting during leisure, running/ jogging and home maintenance/gardening. Validity was indirectly assessed by studying the relationships of total activity to skinfold thickness, total caloric intake, duration on a self-limited maximal exercise test, and high density lipoprotein cholesterol. Less than perfect correlation are expected since physical activity is not the only factor affecting the validation criteria and since physical activity patterns change over time within each person. Comparing the highest physical activity quartile to the lowest physical activity quartile, mean level of sum of three skinfolds was 10.7 mm less for women (correlation coefficient (r) = −0.15, P < 0.001) and 6.9 mm less for men (r = −0.12, P < 0.001); mean level of caloric intake was 158 kcal more for women (r = 0.07, P < 0.001) and 875 kcal more for men (r = 0.21, P < 0.001); mean level of duration on treadmill was 132 seconds more for women (r = 0.36, P < 0.001) and 95 seconds more for women (r = 0.25, P < 0.001); and mean level of high density lipoprotein cholesterol was 4.8 mg/dL more for women (r = 0.13, P < 0.001) and 3.2 mg/dL more for men (r = 0.11, P < 0.001). Reliability was studied in a separate population by comparing questionnaire results in an initial telephone administration with results obtained two weeks later (N = 129). Similar types and amounts of activity were reported in this group as in the group studied for validity. Test-retest correlation coefficients for three summary scores ranged from 0.77 to 0.84, and were at least 0.57 for each of the 13 activity groupings queried. This questionnaire typically takes 5–10 minutes to administer. It yields moderately detailed information about type and amount of usual leisure time physical activity.

ISSN:0883-9212    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Surreptitious ingestion of caffeine prior to graded exercise testing (GXT) may influence the results. Ten coronary artery disease patients and 12 normal subjects participated in a randomized double blind crossover study receiving caffeine (200 mg) and placebo before physical exercise testing. Comparison between the exercise test results following caffeine and placebo ingestion showed no significant differences in maximal heart rate, maximal systolic or diastolic blood pressure, peak &OV0312;O2, ventilatory threshold or maximal workload in both normal and cardiac groups. Acute ingestion of small doses of caffeine-containing beverages prior to GXT should not significantly affect clinical interpretation of routine exercise test results.

ISSN:0883-9212    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Several recent studies have suggested that intake of omega-3 fatty acids may protect against atherosclerosis. In order to determine the effect of this information on clinical practice, we surveyed 290 physicians regarding opinions and usage of fish oil supplements. Additionally, the records of 81 patients taking fish oil were reviewed. Significant findings were: (1) of physicians surveyed, 44 percent saw potential indications for fish oil, and 27 percent had actually recommended it; (2) the most common indications were dyslipidemias and secondary prevention of coronary disease; (3) serum cholesterol and HDL cholesterol were generally followed, while fasting triglyceride levels were rarely measured; (4) the only observed lipid effect was a decrease in serum triglyceride levels.We conclude that in clinical practice, fish oil therapy is commonly recommended for multiple indications. Despite a perception that fish oil would be an effective treatment for hyper-cholesterolemia, the doses used had no effect on total cholesterol, HDL, or LDL cholesterol levels.

ISSN:0883-9212    

出版商:OVID    

年代:1989

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:1989

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:1989

数据来源: OVID