[Prescribing habits of physical activity by cardiac physicians in Côte d'Ivoire]. / Habitudes de prescription de l'activité physique par des médecins cardiologues en Côte d'Ivoire.

Regular physical activity (PA) has multiple health benefits that contribute to the prevention and management of many non-communicable diseases such as cardiovascular disease. However, a large proportion of the world's population is not active enough to benefit its health. Despite the potential of physicians to increase the level of PA practice in both primary and secondary prevention, there appears to be little intervention in this direction during medical consultations. What is the situation in Côte d'Ivoire? We conducted a prospective study that focused on the description and analysis of the practice of PA awareness and prescribing of Côte d'Ivoire cardiologist physicians and to examine the extent to which their socio-cultural characteristicsdemographics, their personal PA practices, barriers and needs influenced their PA prescribing in primary or secondary prevention settings. The results showed a high rate of overweight and obesity (64 %) and a low level of PA (40 %). We noted a high rate of locating (90 %) and advising AP (92 %). High blood pressure (98 %) and obesity (94 %) were the major conditions for which physicians prescribed PA. They were mainly about walking (94 %) and through oral counselling (80 %). Among the brakes identified were mainly the lack of knowledge about PA prescribing, lack of consultation time and lack of motivation of patients in 48 %, 44 % and 34 % of cases respectively. In terms of the needs expressed to promote the prescription of PA, it was mainly the personal conviction of the physician of the interest of prescribing an PA (80 %), of the organization of training on the prescription of PA (78 %) and completion of patient handouts (56 %).

[Tobacco consumption of students ages 8 to 22 in Abidjan, 2002]. / Tabagisme des élèves et étudiants âgés de 8 à 22 ans à Abidjan en 2002.

BACKGROUND: To update full time educated youth data on smoking prevalence related to gender and to assess perception and behaviour related to smoking, we have led a self-administrated question-study from January to June 2002 in Abidjan with students from 8 to 22 years old. METHODS: Our population was divided in 3 groups: T1 (812 years), T2 (13-17 years) and T3 (18-22 years). The size of each group has been determined using the smoking estimated rate in each of them. RESULTS: 2742 students had returned a well-full questionnaire, with the following rates, expressed by mean and standard deviation in%: a total smoking rate at 7.9 +/- 0.5, with statistic difference between boys and girls (11 +/- 0,8 versus 3,7 +/- 0,5; p<0.001). This rate increased with age: 3.7 +/- 0.8 in T1; 12.9 +/- 1.0 in T2 and 17.1 +/- 1,1% in T3. Globally, the rate was 0.7 +/- 0.2 for regular smokers (>or=1 cigarette/day) (10% of C.D.T.) and 1.7 +/- 0.2% for ex-smokers. 99.2% of current smokers used cigarettes only. On average, the tobacco consumption was 3.4 cigarettes/day. In non-smokers group, 88% had respiratory symptoms linked to smoke exposure, with 17% of major dyspnea. Non smokers reported public places as the most frequent (66.7 +/- 1.3%) and the highest long time exposure (44.3 +/- 1.9%) places to second hand smoke. DISCUSSION: A similar smoking prevalence between asthmatics and non-asthmatics subjects, and between sporty type and non sporty type subjects, suggested that students had superficial knowledge or under assessment on smoking detrimental effect. However, their perception of smoking health hazard was sufficient to give 95 +/- 1% favourable opinions on necessary smoking place regulations and 85 +/- 1% favourable opinions on tobacco product advertising ban. CONCLUSION: The epidemiological and behaviour information given by this study might contribute to the development of a national youth tobacco control program, provided a complementary national survey would be led including non educated youth.

[Effect of smoking on PaO2 at rest and during moderate exercise]. / Effet du tabagisme sur la PaO2, au repos et au cours d'un effort physique modéré.

The most data on smoker's arterial oxygen tension (PaO2) were carried out at rest and from non arterial blood sample. The aim of this retrospective study was to compare smokers and nonsmoker's arterial oxygen tension (PaO2) at rest and during a moderate exercise. 98 male smokers between 23 and 69 years old and 98 male nonsmokers with the same age bracket were recruited among subjects submitted to arterial blood gas analysis according to the following protocol: 2 arterial blood samples were taken at rest, with an interval of 5 minutes, followed by a third one taken at the end of a moderate effort (50 watts during 5 minutes) on a bicycle in the supine position. Wilcoxon's test was used to compare the measured biological parameters between smokers and nonsmokers. Unlike nonsmokers, smoker's PaO2 increased meaning fully during moderate exercise. However, like at rest, it remained lower than nonsmoker's PaO2.: 87.6 +/- 15.8 mmHg Versus 94.1 +/- 10.4 mmHg (p < 0.0001). These beneficial effects of exercise on smoker's PaO2, although limited among heavy smokers group, suggested that hypoxia observed at rest must be due to troubles in ventilation/perfusion ratio in the lungs. In comparison to nonsmokers, the most significantly hypoxia was founded in smokers between 40 and 59 years old. The variation of PaO2 in nonsmokers was normal in comparison with age, but strongly disturbed in smokers at rest as well as during a moderate exercise, despite the lack of correlation between PaO2 and the intensity of tobacco consumption (expressed as number of pack-years). Thus, the smokers' PaO2 deterioration concerned together its value and its variation in comparison with age.

Cardiorespiratory and metabolic responses to exercise in HbSC sickle cell patients.

PURPOSE: Relative to healthy control individuals with normal hemoglobin (Hb), patients carrying the double heterozygous form of sickle cell disease (HbSC) display an impaired oxygen transport capacity. The present study was undertaken to determine the influence of the decreased oxygen availability associated with the presence of HbSC on the cardiorespiratory and metabolic responses to endurance exercise. METHODS: Eleven black men affected by the double heterozygous form of the sickle cell disease (HbSC group) and seven healthy subjects with normal Hb (HbAA group) of the same ethnic origin submitted successively to an incremental exercise test to exhaustion on a cycle ergometer for the determination of their maximal tolerated power and to a 20-min endurance exercise. RESULTS: The HbSC had a significantly lower exercise tolerance than the HbAA. During the endurance exercise, they exhibited furthermore significantly lower VO2, VCO2, and minute ventilation V(E) than the HbAA. Despite the fact that the HbSC exercised at a significantly lower mean absolute work rate than the HbAA, except for the ventilatory equivalent for CO2 (V(E)/VCO2), which was higher (P < 0.001) in the HbSC group, the other parameters recorded during the 20-min endurance exercise (heart rate, arterial PaO2, PaCO2, pH, lactate, and VE/VO2, the ventilatory equivalent for O2) and during the subsequent recovery (blood lactate) were similar for both groups. CONCLUSION: The study underscores the importance of considering relative work rate as well as absolute work rate to arrive at a correct interpretation of exercise and recovery data. The results give evidence that the modifications of homeostasis brought into play by exercise were shifted toward distinctly lower absolute work rates in HbSC patients.

Lactate exchange and removal abilities in sickle cell trait carriers during and after incremental exercise.

Arterial blood lactate concentrations and pH were measured on seven black male sickle cell trait (SCT) carriers before, during and after incremental exhaustive bicycle exercise (25 W increments per minute) and compared with those of six control individuals of the same ethnic origin having a similar physical fitness level. The object of the experiment was to determine if SCT has an effect on lactate kinetics. At volitional exhaustion which was reached at a comparable overall mean absolute work rate for both groups, oxygen consumption expressed per kilogram body mass was significantly lower for the SCT carriers than for the control volunteers. Lactate concentrations were higher for the SCT carriers after the 150 W exercise step but differences reached statistical significance only at exhaustion. Concentrations were distinctly higher for the SCT group during the following 40 minutes of recovery. While there were no observable differences in blood pH between the SCT and control subjects during the exercise, this variable became significantly lower for the SCT than for the control group 8 minutes after the end of exercise. Lactate recovery curves were fitted by a biexponential time function where the two velocity constants inform on the body's overall ability to exchange and remove lactate. The ability to remove lactate was comparable for the two groups. The present results do not warrant drawing a definite conclusion on impairment of the ability to exchange lactate in the presence of SCT. However, SCT carriers are likely to produce more lactate than control subjects reaching exhaustion at similar mean absolute work rate during exhaustive incremental bicycle exercise.