ABSTRACT
With ascent to altitude, certain individuals are susceptible to high altitude pulmonary edema (HAPE), which in turn can cause disability and even death. The ability to identify individuals at risk of HAPE prior to ascent is poor. The present study examined the profile of volatile organic compounds (VOC) in exhaled breath condensate (EBC) and pulmonary artery systolic pressures (PASP) before and after exposure to normobaric hypoxia (12% O2) in healthy males with and without a history of HAPE (Hx HAPE, n = 5; Control, n = 11). In addition, hypoxic ventilatory response (HVR), and PASP response to normoxic exercise were also measured. Auto-regression/partial least square regression of whole gas chromatography/mass spectrometry (GC/MS) data and binary logistic regression (BLR) of individual GC peaks and physiologic parameters resulted in models that separate individual subjects into their groups with variable success. The result of BLR analysis highlights HVR, PASP response to hypoxia and the amount of benzyl alcohol and dimethylbenzaldehyde dimethyl in expired breath as markers of HAPE history. These findings indicate the utility of EBC VOC analysis to discriminate between individuals with and without a history of HAPE and identified potential novel biomarkers that correlated with physiological responses to hypoxia.
Subject(s)
Altitude Sickness/metabolism , Hypertension, Pulmonary/metabolism , Hypoxia/metabolism , Pulmonary Artery/physiopathology , Volatile Organic Compounds/metabolism , Adolescent , Adult , Altitude , Altitude Sickness/physiopathology , Blood Pressure , Breath Tests , Case-Control Studies , Discriminant Analysis , Echocardiography, Doppler , Exercise Test , Gas Chromatography-Mass Spectrometry , Humans , Hypertension, Pulmonary/physiopathology , Hypoxia/physiopathology , Male , Oxygen Consumption , Risk Assessment , Volatile Organic Compounds/analysis , Young AdultABSTRACT
OBJECTIVE: To examine the effects of an intensive home-based program of treadmill training on motor skills related to walking in preambulatory children with cerebral palsy (CP). DESIGN: Quasi-randomized controlled trial. SETTING: Homes of the participants. PARTICIPANTS: Children with CP (N=12) with Gross Motor Function Classification System levels I and II were assigned to the intervention group (n=6; mean age ± SD, 21.76±6.50mo) and control group (n=6; 21.25±6.07mo). All children were tested preintervention, postintervention, at a 1-month follow-up, and at a 4-month follow-up. INTERVENTIONS: All children received their weekly scheduled physical therapy sessions at their homes. In addition, children in the intervention group walked on a portable treadmill in their homes 6 times per week, twice daily for 10- to 20-minute sessions, for 6 weeks. The intervention was carried out by the children's parents with weekly supervision by a physical therapist. MAIN OUTCOME MEASURES: Gross Motor Function Measure-66 Dimensions D/E, Peabody Developmental Motor Scales-2 (PDMS-2), Pediatric Evaluation of Disability Inventory (PEDI), timed 10-m walk test (10MWT), and Functional Mobility Scale (FMS). The Friedman test and Mann-Whitney U test were conducted for within-group and between-group differences, respectively. RESULTS: There was a significant between-group treatment effect for the PDMS-2 at posttest (P=.01) and 1-month postintervention follow-up (P=.09), as well as for the PEDI at posttest (P=.01), the 1-month postintervention follow-up (P=.009), and the 4-month postintervention follow-up (P=.04). The FMS was significant at the posttest (P=.04). CONCLUSIONS: Home-based treadmill training accelerates the attainment of walking skills and decreases the amount of support used for walking in young children with CP.
Subject(s)
Cerebral Palsy/rehabilitation , Motor Skills , Walking , Child, Preschool , Female , Home Care Services/organization & administration , Humans , Infant , MaleABSTRACT
PURPOSE: To examine whether an intensive, short-term locomotor treadmill training program helps children with cerebral palsy (CP) younger than 4 years of age improve their gross motor skills related to ambulation, walking speed, and endurance. METHODS: Six children with cerebral palsy, ages 2.5 to 3.9 years, participated in treadmill training 3 times per week for 1-hour sessions consisting of 2 individualized treadmill walks, for 4 weeks, and were tested before and after the intervention and at a 1-month follow-up. The outcome measures included the Gross Motor Function Measure-66, the Pediatric Evaluation of Disability Inventory, a timed 10-m walk test, and a 6-minute walk test. RESULTS: Significant differences were found in the Gross Motor Function Measure-66 Dimensions D and E, the Pediatric Evaluation of Disability Inventory Mobility Scales, over-ground walking speed, and walking distance. CONCLUSIONS: The results of this study provide preliminary evidence that children with CP younger than 4 years of age can improve their gross motor function, walking speed, and walking endurance after intensive locomotor treadmill training.
Subject(s)
Cerebral Palsy/rehabilitation , Exercise Test , Walking , Child, Preschool , Disability Evaluation , Exercise Therapy , Female , Health Status Indicators , Heart Rate , Humans , Male , Physical Endurance , Physical Therapy Modalities , Postural Balance , Treatment OutcomeABSTRACT
Pirfenidone was administered to sensitized Brown Norway rats prior to a series of ovalbumin challenges. Airway hyperresponsiveness, inflammatory cell infiltration, mucin and collagen content, and the degree of epithelium and smooth muscle staining for TGF-beta were examined in control, sensitized, and sensitized/challenged rats fed a normal diet or pirfenidone diet. Pirfenidone had no effect on airway hyperresponsiveness, but reduced distal bronchiolar cell infiltration and proximal and distal mucin content. Statistical analysis showed that the control group and sensitized/challenged pirfenidone diet group TGF-beta staining intensity scores were not significantly different from isotype controls, but that the staining intensity scores for the sensitized/challenged normal diet group was significantly different from isotype controls. These results suggest that pirfenidone treatment is effective in reducing some of the components of acute inflammation induced by allergen challenge.
Subject(s)
Anti-Inflammatory Agents/pharmacology , Asthma/drug therapy , Bronchial Hyperreactivity/drug therapy , Inflammation/drug therapy , Pyridones/pharmacology , Animals , Bronchi/cytology , Bronchi/drug effects , Bronchi/pathology , Bronchial Provocation Tests , Collagen/metabolism , Disease Models, Animal , Lung/drug effects , Lung/pathology , Male , Mucins/metabolism , Muscle, Smooth/drug effects , Muscle, Smooth/pathology , Ovalbumin , Random Allocation , Rats , Rats, Inbred BN , Respiratory Mucosa/drug effects , Respiratory Mucosa/pathology , Transforming Growth Factor beta/metabolismABSTRACT
We examined the effect of dietary supplementation with L-arginine on breath condensate VEGF, exhaled nitric oxide (NO), plasma erythropoietin, symptoms of acute mountain sickness, and respiratory related sensations at 4,342 m through the course of 24 h in seven healthy male subjects. Serum L-arginine levels increased in treated subjects at time 0, 8, and 24 h compared with placebo, indicating the effectiveness of our treatment. L-arginine had no significant effect on overall Lake Louise scores compared with placebo. However, there was a significant increase in headache within the L-arginine treatment group at 12 h compared with time 0, a change not seen in the placebo condition between these two time points. There was a trend (p = 0.087) toward greater exhaled NO and significant increases in breath condensate VEGF with L-arginine treatment, but no L-arginine effect on serum EPO. These results suggest that L-arginine supplementation increases HIF-1 stabilization in the lung, possibly through a NO-dependent pathway. In total, our observations indicate that L-arginine supplementation is not beneficial in the prophylactic treatment of AMS.
