ABSTRACT
We describe a possible association between pulmonary hemosiderosis (PH) and a history of bronchopulmonary dysplasia (BPD). Both patients were born at 28-week gestation and presented with PH at ages 22 months and 6 years, respectively. Both initially presented with cough and tachypnea, and bronchoalveolar lavage showed evidence of hemosiderin-laden macrophages. Initial hemoglobin levels were < 4 g/dL and chest radiographs showed diffuse infiltrates that cleared dramatically within days after initiation of intravenous corticosteroids. In the first case, frank pulmonary blood was observed upon initial intubation, prompting the need for high frequency ventilation, immediate corticosteroids, and antibiotics. The mechanical ventilation wean was made possible by the addition of mycophenolate mofetil (MMF) and hydroxychloroquine. Slow tapering off of medications was accomplished over 6 years. These cases represent a possible correlation between prematurity-associated BPD and PH. We present a review of the literature regarding this possible association. In addition, MMF proved to be life-saving in one of the PH cases, as it has been in pulmonary hemorrhage related to systemic lupus erythematosus. Further studies are warranted to investigate the possible association between PH and prematurity-related BPD, as well as the use of MMF in the treatment of PH.
ABSTRACT
OBJECTIVES: To determine whether objectively measured physical activity levels are associated with physical function and mobility in older men. DESIGN: Cross-sectional. SETTING: Academic research center. PARTICIPANTS: Eighty-two community-dwelling men aged 65 and older with self-reported mobility limitations were divided into a low-activity and a high-activity group based on the median average daily physical activity counts of the whole sample. MEASUREMENTS: Physical activity according to triaxial accelerometers; physical function and mobility according to the Short Physical Performance Battery (SPPB), gait speed, stair climb time, and a lift-and-lower task; aerobic capacity according to maximum oxygen consumption (VO(2) max); and leg press and chest press maximal strength and peak power. RESULTS: Older men with higher physical activity levels had a 1.4-point higher mean SPPB score and a 0.35-m/s faster walking speed than those with lower physical activity levels. They also climbed a standard flight of stairs 1.85 seconds faster and completed 60% more shelves in a lift-and-lower task (all P<.01); muscle strength and power measures were not significantly different between the low- and high-activity groups. Correlation analyses and multiple linear regression models showed that physical activity is positively associated with all physical function and mobility measures, leg press strength, and VO(2) max. CONCLUSION: Older men with higher physical activity levels demonstrate better physical function and mobility than their less-active peers. Moreover, physical activity levels are predictive of performance in measures of physical function and mobility in older men. Future work is needed to determine whether modifications in physical activity levels can improve or preserve physical performance in later life.
