A comprehensive evaluation of 80 consecutive robotic low anterior resections: impact of not mobilizing the splenic flexure alongside low-tie vascular ligation as a standardized technique.

Rectal cancer surgery represents challenges due to its location. To overcome them and minimize the risk of anastomosis-related complications, some technical maneuvers or even a diverting ileostomy may be required. One of these technical steps is the mobilization of the splenic flexure (SFM), especially in medium/low rectal cancer. High-tie vascular ligation may be another one. However, the need of these maneuvers may be controversial, as especially SFM may be time-consuming and increase the risk of iatrogenic. The objective is to present the short- and long-term outcomes of a low-tie ligation combined with no SFM in robotic low anterior resection (LAR) for mid- and low rectal cancer as a standardized technique. A retrospective observational single-cohort study was carried out at Reina Sofia University Hospital, Cordoba, Spain. 221 robotic rectal resections between Jul-18th-2018 and Jan-12th-2023 were initially considered. After case selection, 80 consecutive robotic LAR performed by a single surgeon were included. STROBE checklist assessed the methodological quality. Histopathological, morbidity and oncological outcomes were assessed. Anastomotic stricture occurrence and distance to anal verge were evaluated after LAR by rectosigmoidoscopy. Variables related to the ileostomy closure such as time to closure, post-operative complications or hospital stay were also considered. The majority of patients (81.2%) presented a mid-rectal cancer and the rest, lower location (18.8%). All patients had adequate perfusion of the anastomotic stump assessed by indocyanine green. Complete total mesorectal excision was performed in 98.8% of the patients with a lymph node ratio < 0.2 in 91.3%. The anastomotic leakage rate was 5%. One patient (1.5%) presented local recurrence. Anastomosis stricture occurred in 7.5% of the patients. The limitations were small cohort and retrospective design. The non-mobilization of the splenic flexure with a low-tie ligation in robotic LAR is a feasible and safe procedure that does not affect oncological outcomes.

Detección de papilomavirus humano en mucosa oral en hombres con verrugas anogenitales / Detection of human papillomavirus in oral mucosa in men with anogenital warts

El virus del papiloma humano (HPV) es el agente etiológico de infecciones de transmisión sexual relacionadas con procesos oncogénicos genitales y orales. La biología molecular, mediante la identificación de los tipos virales involucrados, proporciona precisión diagnóstica con un enfoque epidemiológico. El objetivo de este estudio fue determinar la presencia de HPV en la mucosa oral de hombres con verrugas anogenitales y correlacionar los genotipos detectados en ambas muestras. Se estudiaron 26 pacientes varones con verrugas anogenitales que acudieron al Instituto de Dermatología de la ciudad de Resistencia (Argentina). La presencia de HPV en muestras orales y anogenitales se estudió mediante reacción en cadena de la polimerasa (PCR) y la genotipificación se realizó mediante PCR-RFLP. La prevalencia de HPV oral en pacientes con HPV anogenital fue del 46,2% (12/26). Se encontraron dieciocho genotipos con alto riesgo oncogénico en muestras orales de pacientes con infecciones únicas o múltiples y el tipo 16 fue el más frecuente (6 pacientes). Catorce genotipos en muestras orales fueron de bajo riesgo oncogénico, el más frecuente fue el tipo 6 (10 pacientes). En muestras anogenitales el genotipo 6 fue el más frecuente (13 pacientes), solo o en coinfección. Se encontró una alta prevalencia de HPV oral de malignidad de alto grado en nuestra población y coinfección con tipos oncogénicos. Las prácticas de sexo oral fueron la principal conducta de riesgo para la infección, lo que quedó demostrado por el hallazgo simultáneo del mismo tipo de HPV en muestras orales y anogenitales

The human papillomavirus (HPV) is the etiologic agent of sexually transmitted infections related to genital and oral oncogenic processes. Molecular biology provides accurate diagnosis with an epidemiological approach, by identifying the viral types involved. The objective of this study was to determine the presence of HPV in oral mucosa from men with anogenital warts and to correlate the genotypes detected in both samples. Twenty-six male patients suffering anogenital warts who attended to the Institute of Dermatology in Resistencia (Argentina) were studied. The presence of HPV in oral and anogenital samples was studied by PCR and genotyping was performed by PCR-RFLP. The prevalence of oral HPV in patients with anogenital HPV was 46.2% (12/26). Eighteen genotypes with high oncogenic risk were found in oral samples of patients with single or multiple infections and type 16 was the most frequent (6 patients). Fourteen genotypes in oral samples were of low oncogenic risk and the most frequent was type 6 (10 patients). In anogenital samples the genotype 6 was the most frequent (13 patients), alone or in co-infection. A high prevalence of high-grade malignancy oral HPV in our population and co-infection with oncogenic types were found. Oral sex practices were the main risk factor for infection, which was demonstrated by the simultaneous finding of the same HPV type in oral and anogenital samples

Design and evaluation of an incoherent feed-forward loop for an arsenic biosensor based on standard iGEM parts.

The diversity and flexibility of life offers a wide variety of molecules and systems useful for biosensing. A biosensor device should be robust, specific and reliable. Inorganic arsenic is a highly toxic water contaminant with worldwide distribution that poses a threat to public health. With the goal of developing an arsenic biosensor, we designed an incoherent feed-forward loop (I-FFL) genetic circuit to correlate its output pulse with the input signal in a relatively time-independent manner. The system was conceived exclusively based on the available BioBricks in the iGEM Registry of Standard Biological Parts. The expected behavior in silico was achieved; upon arsenic addition, the system generates a short-delayed reporter protein pulse that is dose dependent to the contaminant levels. This work is an example of the power and variety of the iGEM Registry of Standard Biological Parts, which can be reused in different sophisticated system designs like I-FFLs. Besides the scientific results, one of the main impacts of this synthetic biology project is the influence it had on team's members training and career choices which are summarized at the end of this article.

Paracoccidioidomicosis: presentación inusual / Paracoccidioidomicosis: presentación inusual

Se presenta un paciente masculino, de 63 años de edad, con antecedentes de enfermedad de Leriche y colocación de prótesis vascular. Es internado en terapia intensiva por infarto intestinal e isquemia aguda de miembro inferior derecho por lo cual es intervenido quirúrgicamente. Mediante el hallazgo de Paracoccidioides sp en prótesis vascular y otros órganos internos, asociados a lesiones cutáneas y compromiso pulmonar, se realiza el diagnóstico de paracoccidioidomicosis crónica multifocal. Destacamos el compromiso de la prótesis como parte de la diseminación fúngica (AU)

A 63-year-old male patient with a history of Leriche disease and vascular prosthesis placement is reported. He is admitted to intensive care unit with intestinal infarct and acute ischemia of his right lower limb for which he underwent surgery. Paracoccidioides sp findings in vascular prostheses and other internal organs, associated with skin lesions and pulmonary involvement, allowed the diagnosis of chronic multifocal paracoccidioidomycosis. We emphasize the commitment of the prosthesis as part of fungal dissemination on this case (AU)

Insuficiencia renal aguda secundaria a diarrea severa por enteropatía esprue-like asociada a olmesartán / Acute renal failure secondary to diarrhea due to sprue like-enteropathy associated with olmesartan

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Paracoccidioidomicosis genital: localización infrecuente / Genital Paracoccidioidomycosis: Uncommon Location

Se presenta el caso de un paciente de 74 años, agricultor, oriundo de Paraguay, quien consultó por ulceraciones genitales de 2 meses de evolución, asintomáticas. Se realizaron exámenes microbiológicos (directo y cultivo) y biopsia de una de las lesiones, hallándose Paracoccidioides sp. Se inicia tratamiento con itraconazol 200 mg/día con buena respuesta. Existen escasas publicaciones acerca de esta forma de presentación. Planteamos la necesidad de considerarla en el diagnóstico diferencial de las patologías genitales en áreas endémicas...

Lepra visceral: presentación de un caso / Visceral leprosy: a case report

La lepra es una enfermedad infectocontagiosa crónica que puede presentarse con afectación cutánea, nerviosa y/o visceral según el perfil inmunológico del paciente. El Mycobacterium leprae puede producir afectación visceral de forma directa y/o indirecta. El compromiso hepático es más frecuente en los casos multibacilares. Presentamos un paciente de sexo masculino de 52 años con lepra lepromatosa y compromiso hepático

Leprosy is a chronic infectious disease that may present with skin, nervous and /or visceral involvement, according to immune profiles of patients. Mycobacterium leprae may cause visceral affection in a direct or indirect way. Liver involvement is more common in multibacillary cases. A case of lepromatous leprosy with liver compromise in a 52-year-old male patient is presented.

Asociación entre diferentes factores y artritis psoriásica en pacientes del centro dermatológico “Dr. Manuel M. Giménez” en resistencia, Chaco (Argentina) / The association of different factors with psoriatic arthritis in patients at dermatology center “Dr. Manuel M. Giménez” in resistencia, Chaco (Argentina)

Introducción: La artritis psoriásica (AP) comprende una serie de alteraciones osteoarticulares que pueden asociarse a psoriasis cutánea (Ps). Objetivo: Evaluar la asociación entre diferentes factores y la presencia de AP en pacientes con Ps que se atienden en nuestro servicio. Materiales y métodos: Se incluyeron 236 pacientes con diagnóstico clínico y/o histopatológico de Ps, con y sin afectación articular, que habían sido evaluados en los consultorios externos del Centro Dermatológico "Dr. Manuel M. Giménez" de la ciudad de Resistencia, provincia del Chaco (Argentina), desde el 1 de junio del 2005 hasta el 31 de mayo del 2014. Se realizó análisis bivariado y regresión logística no condicional para evaluar asociaciones entre diferentes variables y la presencia de AP. Se consideraron significativos valores de p menores a 0,05. Resultados: De 236 pacientes consultantes por Ps cutánea, 87 (36,7%) presentaron AP. La edad promedio de los afectados de Ps con AP fue de 47,2 años y en los pacientes sin AP fue de 44,4. Con respecto al sexo, 51,7% de los pacientes con AP fueron de sexo femenino, mientras que en los pacientes sin AP la proporción de sexo femenino fue de 28,8%. De los pacientes con AP, el 79,3% presentó onicopatía y de los pacientes sin AP tuvo el 38,9%. La superficie cutánea evaluada por PASI tuvo un promedio de 11,2 en pacientes con AP y 10,1 en aquellos sin AP. En relación a los años de evolución de la Ps se observó una de 10,1 años en personas con AP y de 5,8 años en personas sin AP. Conclusiones: Nuestro estudio evidenció una diferencia estadísticamente significativa de padecer AP en presencia de psoriasis ungueal y el sexo femenino con mayor asociación.

Introduction: The Psoriatic arthritis (PA) is associated with a seriesof osteoarticular alterations that can be related to cutaneous Psoriasis(Ps). Objective: to evaluate the association of different factors with the presence of PA in patients with Ps who are treated in our service. Materials and methods: 236 patients with a clinical and/or histopathology diagnosis of Ps, with or without articular involvement, who were assessed in the consulting rooms at the Dermatology Centre "Dr. Manuel M. Giménez", Resistencia city, province of Chaco (Argentina), since June 1st. 2005 to May 31st. 2014, were included in the study. A bivariate and non-conditional logistic regression analysis was used to evaluate the associations of different variables and the presence of PA. Significant values of pless than 0.05 were considered. Results: 87 (36.7%) out of 236 patients with cutaneous Ps had PA. The average age of patients who developed Ps with PA was of 47.2 and the average age in patients without PA was of 44.4. As regards sex, 51.7% of the patients with PA were females. Whereas in patients without PA, the amount of females was of 28.8%. Onicopathy was observed in 79.3% of the patients with PA and in 38.9% of the patients without PA. The cutaneous surface evaluated by PASI score showed an average of 11.2 in patients with PA and 10.1 in the ones without PA. As regards, the years of evolution with Ps, 10.1 years was observed in one of the subjects with PA and 5.8 years insubjects without PA. Conclusions: Our study has shown a statistically significant difference of having PA with the presence of nail psoriasis and a higher association with females.

Herpes Zóster diseminado / Disseminated herpes zoster

El herpes zóster diseminado es una erupción generalizada de más de 20 vesículas extra-dermatomasque ocurren dentro de la semana del inicio del herpes zóster clásico. Presentamos un paciente inmunocompetente con herpes zóster diseminado, con buena respuesta terapéutica de las lesiones cutáneas tratadas con aciclovir vía oral a una dosis de 4 g/día durante 10 días.El herpes zóster diseminado es una infección potencialmente grave que se puede presentaren ausencia de inmunosupresión.El diagnóstico precoz y el tratamiento oportuno reducen la morbimortalidad y la gravedad de las complicaciones...

Two-step stool aerobic training for smokers.

OBJECTIVE: The aim of this study was to analyze subjective, physical, and physiologic responses to a standardized incremental 30-min two-step stool test to create an individualized 45-min maximally intensive two-step stool endurance exercise regimen for home training. DESIGN: This is a longitudinal study on 26 consecutively referred male smokers aged 39-66 yrs. Each performed the two-step stool test on two 15-cm steps at 10, 20, 30, 40, 50, and 60 climbs per minute. Exertional dyspnea, oxygen consumption per unit time, ventilation, respiratory rate, tidal volume, heart rate, capillary oxyhemoglobin saturation, physiologic cost index, and oxygen pulse were recorded and compared with those observed during incremental cycle exercise (30 W per 3 mins). Multivariate analysis for each parameter was undertaken as a mixed model. RESULTS: All subjects attained 60 climbs per minute on the two-step stool test and performed 38-42 mins of two-step stool endurance. All parameters reached 80%-96% of cycle maximum oxygen consumption. The subjects found the two-step stool endurance simple and practical to perform at home. There were no complications. CONCLUSIONS: The incremental two-step stool test is a simple, cost-effective way to establish a 45-min maximally intensive endurance exercise training program practical for use in the home.

Paracoccidioidomicosis, TBC y SIDA / Paracoccidioidomycosis, TB and AIDS

Presentamos un paciente de sexo masculino de 54 años con una asociación poco frecuente de tres entidades: paracoccidioidomicosis, SIDA y tuberculosis...

Bilevel exercise training and directed breathing relieves exertional dyspnea for male smokers.

OBJECTIVE: The purpose of this study was to compare the effects on exertional dyspnea and exercise capacity of square wave (bilevel) cycle ergometry endurance exercise training (SWEET) and comprehensive directed breathing vs. walking while pushing an OxCar and traditional diaphragmatic breathing for male smokers with normal spirometry but reduced exercise capacity. DESIGN: This was a prospective randomized trial of 24 unmedicated men with exertional dyspnea assigned to SWEET or OxCar groups. Exertional dyspnea was assessed using the Borg scale during four tests: incremental exercise, constant exercise at 80% of the peak work rate (PWR) (maximum tolerated for 3 mins before exhaustion), SWEET, and 6-min walk test. Both groups trained for 45 mins, 5 days a week, for 6 wks. Before, during, and after training, 32 lung function parameters were studied at ventilatory anaerobic threshold, at PWR, and during incremental exercise (30 W/3 mins). RESULTS: For the SWEET group, exertional dyspnea and the dyspnea index decreased during incremental exercise, at the ventilatory anaerobic threshold, and at PWR (P < 0.01). At the ventilatory anaerobic threshold, oxygen consumption increased by 74%; minute ventilation, 30%; tidal volume, 91%; and ventilatory efficiency and oxygen pulse (O(2)P), 25%; and breathing rate (breathing frequency) decreased by 32% (all significant at P < 0.001). At PWR, oxygen consumption increased by 30%; minute ventilation, 37%; breathing rate, 21%; and ventilatory efficiency and oxygen pulse, 25% (P < 0.01). During the full incremental test, minute ventilation, breathing frequency, and heart rate (cardiac frequency) decreased significantly (P < 0.01). In addition, there was significant improvement (P < 0.001) in SWEET intensity by 63%, constant exercise intensity at 80% of PWR by 38%, and 6-min walk test by 30%. No significant changes were observed for the OxCar group other than for the 6-min walk test, which increased by 7% (P < 0.05). CONCLUSIONS: This study suggests that the decline in exercise tolerance for male smokers can be reduced by intensive exercise training (SWEET) and comprehensive directed breathing but not by moderate training and traditional diaphragmatic breathing. Thus, some smokers can be helped despite continuing to smoke.

Comprehensive directed breathing retraining improves exertional dyspnea for men with spirometry within normal limits.

OBJECTIVE: To compare the effects of comprehensive directed breathing retraining with traditional diaphragmatic breathing on male smokers with exertional dyspnea but normal spirometry. DESIGN: This is a prospective randomized clinical trial in an exercise laboratory at a university hospital. Twenty-four nonmedicated exertional dyspnea subjects were randomly assigned to experimental (comprehensive directed breathing) and control (traditional diaphragmatic breathing) groups. Forty-four physiologic parameters associated with exertional dyspnea were studied before and after interventions for both groups at rest and at 40-W constant exercise for 10 mins. The interventions for both groups included diaphragmatic breathing exercises, walking, and arm exercises for 90 mins, 5 days/wk for 4 wks. In addition, the comprehensive directed breathing group was taught the anatomy and physiology of ventilation; they observed their ventilatory dyssynchrony in a mirror; they were shown their ventilatory rhythm on a spirogram; diaphragmatic movement was demonstrated in an educational movie; and verbal feedback was used to correct respiratory asynchrony. RESULTS: We compared the relative changes of lung function parameters before and after intervention for each group. The comprehensive directed breathing group improvements were significantly greater (P < 0.05) than those of traditional diaphragmatic breathing for 34 of 44 lung function parameters. CONCLUSIONS: Comprehensive directed breathing training improved exertional dyspnea, Dyspnea Index, and some clinical and functional parameters significantly more than traditional diaphragmatic breathing training.

Estado actual de la pitiriasis rosada en el Chaco / Pityriasis Rosea in the province of Chaco

La pitiriasis rosada es una enfermedad eritematoescamosa autolimitada que afecta exclusivamente la piel con probable etiología viral. Se realizó un trabajo descriptivo observacional prospectivo donde se incluyeron 119 pacientes que consultaron en nuestro servicio en un periodo de 2 años. El objetivo fue analizar las diferentes formas clínicas y variables que intervienen en dicha patología. En los resultados destacamos que el hallazgo de formas clínicas típicas fue 75,4% y atípicas en un 24,6%. El Estrés psicofísico actuó como desencadenante en un 39,5% de los casos, mientras que en el hemograma se observó la presencia de monocitosis en un 82,1% de los pacientes y eosinofilia en un 22,1%. Resultaría de interés, en investigaciones futuras, la evaluación del estrés psicofísico como factor desencadenante del cuadro dermatológico, considerando que no ha sido desarrollado apropiadamente en la bibliografía consultada.

Pilomatrixoma: una presentación atípica / Pilomatrixoma: an atypical presentation

El pilomatrixoma es un tumor cutáneo epitelial benigno derivado de las células de la matriz del folículo piloso. Es una patología poco frecuente, con mayor incidencia en niños y adultos jóvenes. Clínicamente se presenta como un tumor único, dérmico o subcutáneo, que tiende a calcificarse. Presentamos un caso de pilomatrixoma perforante en una niña de 8 años de edad, el cual constituye una presentación clínica inusual.

Pilomatrixoma is a benign epithelial cutaneous tumor derived from hair matrix cells. It is an uncommon condition but its occurrence is mostly in children and young adults. Clinically, it manifests as a solitary, dermal or subcutaneous tumor, which is prone to calcification. We discuss a case of a perforating pilomatrixoma occurring in an 8-year-old girl for this is an atypical clinical variety of this benign tumor.

[Role of HLA-DR and HLA-DQ alleles in multibacillary leprosy and paucibacillary leprosy in the province of Chaco (Argentina)]. / Papel de las moléculas HLA-DR y HLA-DQ en la lepra multibacilar y paucibacilar en la provincia del Chaco; Argentina.

OBJECTIVES: Segregation analyses in several populations have suggested a relationship between specific human leukocyte antigen (HLA) class II alleles and the development of different types of leprosy. The aim of this study was to determine the frequency of HLA class II DR and DQ alleles among leprosy patients in Chaco province, northeast Argentina, in an effort to determine whether these alleles might be involved in the development of the multibacillary (MB) and paucibacillary (PB) forms of leprosy. PATIENTS AND METHODS: Samples from 89 leprosy patients (MB = 70, PB = 19) and 112 healthy control subjects were analyzed. The HLA-DRB1 and HLA-DQB1 alleles were determined by PCR amplification and reverse hybridization with sequence-specific oligonucleotide probes, and analyzed with the INNO-LiPA typing system and LiPA software. DQB1*0201/0202/0203 in patients with MB leprosy and DRB1*04 in patients with PB leprosy were detected at significantly lower frequencies as compared with the normal controls. RESULTS: These data indicate that DQB1* 0201/0202/0203 may be a protective factor in MB leprosy and DRB1*04 in PB leprosy. DISCUSSION: We attribute the differences between our findings and those of other authors to the fact that the Caucasian inhabitants of Chaco include a considerable mixture of South American natives (Guaraníes and Tobas).

Papel de las moléculas HLA-DR y HLA-DQ en la lepra multibacilar y paucibacilar en la provincia del Chaco; Argentina / Role of HLA-DR and HLA-DQ alleles in multibacillary leprosy and paucibacillary leprosy in the province of Chaco (Argentina)

Objetivo. En la lepra, el análisis de segregación en varias poblaciones humanas sugiere una relación de alelos particulares de los antígenos leucocitarios humanos (HLA) clase II con el desarrollo de las diferentes formas de la enfermedad. Con el objetivo de determinar si algún alelo de las moléculas de HLA clase II en la población de la provincia del Chaco, Argentina, podrían estar comprometidos en el desarrollo de algunas de las formas de lepra multibacilar (MB) y/o paucibacilar (PB), se determinó la frecuencia de los alelos de los loci DR y DQ en pacientes con lepra. Pacientes y métodos. Se analizaron 89 muestras de pacientes con lepra (MB 5 70; PB 5 19) y 112 controles sanos. Se determinaron los alelos del locus DR y DQ, utilizando amplificación genérica por reacción en cadena de la polimerasa (PCR) e hibridación reversa con oligonucleótidos específicos (LIPA KEY-INNOGENETICS). Se encontró una disminución en la frecuencia del alelo DQB1*0201/0202/0203 en pacientes con lepra multibacilar y disminución del alelo DRB1*04 en pacientes con lepra paucibacilar respecto a controles, ambos con significación estadística. Resultados. Según los resultados observados, DQB1*0201/0202/0203 podría ser un alelo de protección en la forma multibacilar de la lepra y el alelo DRB1*04 estaría relacionado con protección en lepra paucibacilar. Discusión. Pensamos que las diferencias halladas con otras poblaciones caucásicas reportadas por otros autores se deben a que la población chaqueña de origen caucásico tiene una fuerte mezcla con nativos de América del Sur, guaraníes y tobas (AU)

Objectives. Segregation analyses in several populations have suggested a relationship between specific human leukocyte antigen (HLA) class II alleles and the development of different types of leprosy. The aim of this study was to determine the frequency of HLA class II DR and DQ alleles among leprosy patients in Chaco province, northeast Argentina, in an effort to determine whether these alleles might be involved in the development of the multibacillary (MB) and paucibacillary (PB) forms of leprosy. Patients and methods. Samples from 89 leprosy patients (MB 5 70, PB 5 19) and 112 healthy control subjects were analyzed. The HLA-DRB1 and HLA-DQB1 alleles were determined by PCR amplification and reverse hybridization with sequence-specific oligonucleotide probes, and analyzed with the INNO-LiPA typing system and LiPA software. DQB1*0201/0202/0203 in patients with MB leprosy and DRB1*04 in patients with PB leprosy were detected at significantly lower frequencies as compared with the normal controls. Results. These data indicate that DQB1* 0201/0202/0203 may be a protective factor in MB leprosy and DRB1*04 in PB leprosy. Discusion. We attribute the differences between our findings and those of other authors to the fact that the Caucasian inhabitants of Chaco include a considerable mixture of South American natives (Guaraníes and Tobas) (AU)

Noninvasive ventilatory assistance during exercise for patients with kyphoscoliosis: a pilot study.

The goal was to determine whether noninvasive ventilatory assistance (NIV) could facilitate exercise performance and benefit physiologic parameters for eight hypercapnic kyphoscoliosis patients using a cycloergometer for 6-min periods at a constant power (20 W). The exercise protocols were performed in random order while breathing unaided (spontaneous breathing test or SBT) and also while receiving NIV (NIV test or NIVT). The NIV was pressure support (15 cm H2O) plus positive end expiratory pressure (PEEP) (4 cm H2O) via a nasal mask. Of the compared parameters, heart rate was not significantly different, but acidosis (pH = 7.32 +/- 0.04 vs. 7.36 +/- 0.04), hypoxia (PaO2 = 61.5 +/- 15.9 vs. 69.5 +/- 15.7 mm Hg), and hypercapnia (PaCO2 = 54.3 +/- 7.6 vs. 47.1 +/- 7.1 mm Hg) were significantly greater for the SBT than for the NIVT (P < 0.05). The hypercapnia and hypoxia for the NIVT were not significantly greater than preexercise resting levels. Dyspnea and perceived effort were significantly greater for the SBT (P < 0.05). In conclusion, NIV can improve clinical and physiologic response to exercise.