Metabolic and cardiorespiratory response in swimmers during head-out immersion: a prospective study

Sport represents a stress for the body. Many metabolic and cardiorespiratory changes are known during physical activity. However, little is known in swimmers particularly during head-out immersion. To determine the metabolic and cardiorespiratory response in swimmers during head-out immersion. The energetic, cardiovascular function and ventilatory requirements of a 10 min steady state arm exercise performed by 13 healthy subjects in air and during immersion up to the hip in 26[degree sign]C water were compared. The same ergometric work load was achieved with an average maximum oxygen uptake of 3.9 +/- 2.63 l/min in air versus 3.55 +/- 2.48 l/min in water [p=0.953]. During exercise, the average values of minute ventilation, ventilation equivalent for oxygen, ventilation equivalent for CO2, peak expiratory flow, respiratory exchange ratio and heart rate were not different in water and in air. However, first ventilatory threshold was significantly higher in water than in air. The mean value of the first ventilatory threshold was 0.89 +/- 0.23 l/min in air, and 1.08 +/- 0.23 l/min in water immersion; [p=0.016]. These results suggest that training swimmers favoring immersion [weight belts] may improve their aerobic capacity

syndrome of combined pulmonary fibrosis and emphysema

A syndrome associating an upper-lobe emphysema and pulmonary fibrosis of the lower lung was recently characterized. Few cases were identified in the literature. We report a case of a 68 year- old smoker man presented for exacerbation of a severe dyspnea. Physical examination revealed basal crackles and finger clubbing. Blood gas analysis showed hypoxemia. Chest radiography showed features compatible with emphysema of the upper lobes and fibrosis of the basis. Chest computed tomography confirmed chest radiography's findings and revealed fibrosis. The diagnosis of idiopathic pulmonary fibrosis was made. Pulmonary function tests showed obstructive pattern. Systolic pulmonary arterial pressure was elevated up to 87 mm Hg on heart ultrasonography. The authors emphasize the importance of the diagnosis of this entity made through chest computed tomography and the fact that it is characterized by severe impairment of gas exchange, the high prevalence of pulmonary hypertension and poor survival

[Asthma control status in Tunisia]

Transversal study during hospital allergology visit which aim is to evaluate asthma control levels in Tunisia. Questionnaire issue of global initiative for asthma [GINA] guidelines. 400 asthmatics were included [70%of women and 30%men], aged 32 +/- 11 years old. Asthma was intermittent in 43%of patients, mild persistant [27%], moderate [14%] and severe in 16%of patients. Daytime symptoms were observed in 56%of cases, nocturnal symptoms in 40%, exacerbations in 39%of cases, activities limitation in 44%of cases and need of rescue treatment in 56%. Controller medications were used in 63%of patients. Inhaled Gluocorticosteroids were used in 90%of patients with persistent asthma. Subjective self evaluation of asthma showed that 83%of patients felled better with treatment, whereas, asthma objective control was obtained only in 10%of them. For the rest, asthma was partly controlled in 35%of patients and uncontrolled in 55%. College and professional absenteeism was observed in 60%of cases, with a mean of 1 to 5 days per month. Control factors seem to be young age, non smoker status and mild persistent asthma. Although GINA 2006 guidelines and treatment progress, an important rate of asthmatics [90%] continue to present symtoms, underuse their treatment and Overestimate control level of their disease