Adaptations to endurance training in the healthy elderly: arm cranking versus leg cycling

The effect in healthy elderly subjects of cycle ergometer or arm ergometer training on peak oxygen consumption (VO(2peak)) and ventilatory threshold (VT) was studied. The aim was to determine the benefit of each training modality on specific and cross exercise capacity. The cross-effect was also evaluated as an index of the central nature of the adaptive response to training. Twelve non-smoking healthy males (age: 67 +/- 5 year; body mass: 75 +/- 9 kg) were randomly divided in two age-matched groups of six, performing an arm cranking (ARM) or a cycloergometer (CYC) training (12-week, 30 min, 3 times/week), while a third group of 6 subjects (age: 73 +/- 4 year; body mass: 80 +/- 8 kg) performed no training (control, C). At baseline and following the intervention, subjects carried out an incremental test to exhaustion both on the ergometer on which they trained (specific test) and on the other ergometer (cross test). Respiratory variables were measured breath by breath and heart rate (HR) was recorded. Peak oxygen consumption (VO(2peak)), ventilation (VE(peak)), oxygen pulse (O2P(peak)) and heart rate (HR(peak)) were averaged over the last 10 s of exercise. Following training, while HR(peak) remained unchanged, significantly higher W(peak), VO(2peak), VE(peak) and O2P(peak) were obtained in both training groups, on both ergometers. The amplitude of the increase in W(peak), VO(2peak) and O2P(peak) was significantly higher for specific than for cross tests ( approximately 19% vs. approximately 8 % in CYC; approximately 22% vs. approximately 9% in ARM, P < 0.01) while the increase in same test condition was similar. No change was observed in the C group. The results indicate that aerobic training brought about with different muscle masses, produce similar improvements in maximal and submaximal exercise capacity. Roughly half of such improvements are specific to exercise mode, which suggests peripheral adaptations to training. The other half is non-specific since it influences also the alternative exercise modality, and is probably due to central adaptations.

Evidence of the rapid protective effect of formoterol dry-powder inhalation against exercise-induced bronchospasm in athletes with asthma

BACKGROUND

Although formoterol, a new long-acting beta(2)-adrenergic agonist, has a rapid bronchodilating action, no studies have previously examined whether it can provide equally rapid protection against exercise-induced bronchospasm (EIB).

AIM

The aim of the study was to assess the effect of inhaled formoterol against EIB 15 min and 4 h after administration in asthmatic athletes.

METHODS

The protective effect of a formoterol (12 microg) dry-powder inhalation was evaluated in 14 EIB-positive asthmatic athletes (13 males, mean age 16.8 years), in a double-blind, placebo-controlled, two-period cross-over study. On each treatment day, the subjects underwent two cycloergometric exercise tests 15 min and 4 h after receiving formoterol or placebo.

RESULTS

Formoterol induced significant bronchodilation in comparison with placebo both 15 min and 4 h after administration (p = 0.007 and p = 0.004); placebo treatment had no effect on EIB, the maximum percent fall in FEV(1) after exercise being 29.3 +/- 14.3% and 22.9 +/- 13. 7% at 15 min and 4 h, respectively. Formoterol offered good protection against EIB in 12 athletes (86%) who experienced a decrease in FEV(1) after exercise <10% both 15 min and 4 h after administration. The mean maximum percent fall in FEV(1) after formoterol was 5.9+/-7.2% at 15 min (p < 0.0001), and 5.8 +/- 6.9% at 4 h (p < 0.0001). There was no statistically significant difference in resting heart rate before and after medication with placebo or formoterol, nor was the heart rate at the end of exercise significantly different on the 2 treatment days. No side effect was observed in either group.

CONCLUSIONS

This study demonstrates that formoterol dry powder inhalation is effective in protecting asthmatic athletes as early as 15 min after dosing. Furthermore, the data confirm the long duration of its protective effect and the absence of any significant adverse effects after acute administration.

Seroprevalence of Chlamydia pneumoniae antibodies in a young adult population sample living in Verona. European Community Respiratory Health Survey (ECRHS) Verona

The aim of the study was to evaluate the prevalence of antibodies to Chlamydia pneumoniae in a random population sample of 369 young adults (aged 20-44 years), living in Verona, Italy. IgG and IgM titers were measured by micro-immunofluorescence. IgG antibodies, greater or equal to 16, were found in 104/177 (58.8%) men and 76/192 (39.6%) women (p < 0.001). No relationship was found between IgG seropositivity, age, social class, education and family size. Factors positively associated with IgG seropositivity included smoking (p < 0.001), occupational status (employed vs unemployed: p = 0.02; students vs unemployed: p < 0.01) and living area (suburban [65.0%] vs urban area [45.3%]: p = 0.03). The geometric mean of IgG titers was higher in students (GM: 26.05) than in both employed (GM: 11.02) and unemployed persons (GM: 4.80) (p < 0.01 and p < 0.001, respectively). IgG titres > or = 512 and/or IgM titers > or = 16 (suggestive of a recent C. pneumoniae infection) were found in 39 subjects (10.6%). Recent infection was more frequent in spring (14.9%), with no significant variation in the other seasons (mean prevalence 6.7%) (p < 0.01). Recent infection was also associated with cigarette smoking. On the other hand, no significant association was found between respiratory symptoms and serologic evidence of recent infection.

IN CONCLUSION

1) the prevalence of antibodies to C. pneumoniae in young adults from Verona is similar to that found in European countries, and therefore, in Europe, it seems not related to latitude or climate; 2) male sex, tobacco smoking, employment status and living in a suburban area are independent risk factors of infection; 3) the infection is subclinical in most cases.

Serious childhood respiratory infections and asthma in adult life. A population based study. ECRHS Italy. European Community Respiratory Health Survey

BACKGROUND

A number of epidemiologic studies have tried to establish whether respiratory tract infections in early childhood cause obstructive pulmonary disease in adult life.

OBJECTIVE

To determine whether reported serious respiratory infection before the age of 5 years (SRI) is a significant risk factor for subsequent development of bronchial asthma and/or bronchial hyperresponsiveness in adults.

METHODS

We investigated a random population sample of 1,104 subjects (aged 20 to 40 years), participating in the European Respiratory Health Survey in Italy. Bronchial response to methacholine and answers to a standardized questionnaire were analyzed.

RESULTS

The prevalence of SRI (ie, a positive response to the question "Have you ever had a serious respiratory infection before the age of 5 years?") was significantly higher in the subjects with a positive family history of allergic diseases than in those with a negative one (O.R. 1.89; 95% C.I. 1.24 to 2.87, P < .01). No relationship was found between SRI and current adult asthma; however, asthma in the past was found in 20.5% of the SRI positive subjects and in 9.1% of SRI negative subjects (O.R. 2.47; 95% C.I. 1.47 to 4.15, P < .05). No difference in the response to methacholine and in FEV1, FEV1/FVC values was found between SRI positive and SRI negative subjects.

CONCLUSIONS

We suggest that a positive family history of atopy is associated with a significantly higher prevalence of SRI. Furthermore our results indicate that exposure to SRI is a risk factor for asthma in the past (ie, asthma in childhood and adolescence) but not for adult asthma or for the development of bronchial impairment in adult life.