Gökhan Metin

Regular Aerobic Training Combined with Range of Motion Exercises in Juvenile Idiopathic Arthritis

Objective. To assess the effects of regular aerobic training combined with range of motion (ROM) exercises on aerobic capacity, quality of life, and function in children with juvenile idiopathic arthritis (JIA). Methods. Thirty patients with JIA and 20 healthy age-matched controls (mean age ± SD, 11.3 ± 2.4 versus 11.0 ± 2.3, resp.; P > 0.05) were included. All patients performed aerobic walking (4 days a week for 8 weeks) and active and passive ROM exercises of involved joints. All patients completed the childhood health assessment questionnaire (CHAQ) and the child health questionnaire. ROM measurements of joints were performed by using universal goniometer. Aerobic capacity was determined by measuring peak oxygen uptake (VO2peak) during an incremental treadmill test. Results. Peak oxygen uptake and exercise duration were significantly lower in JIA group than in controls (32.5 ± 6.6 versus 35.9 ± 5.8 and 13.9 ± 1.9 versus 15.0 ± 2.0, resp.; P < 0.05 for both). Eight-week combined exercise program significantly improved exercise parameters of JIA patients (baseline versus postexercise VO2peak and exercise duration, 32.5 ± 6.6 to 35.3 ± 7.9 and 13.9 ± 1.9 to 16.3 ± 2.2, resp.; P < 0.001 for both). Exercise intervention significantly improved CHAQ scores in JIA patients (0.77 ± 0.61 to 0.20 ± 0.28, P < 0.001). Conclusion. We suggest that regular aerobic exercise combined with ROM exercises may be an important part of treatment in patients with JIA.

FEF25–75/FVC measurements and extrathoracic airway obstruction in obstructive sleep apnea patients

The aims of this study were to evaluate patients with obstructive sleep apnea syndrome (OSAS) with regards to dysanapsis (airway size relative to lung size) and to demonstrate the differences between the patients with and without extrathoracic airway obstruction. The study population consisted of 15 patients with OSAS and 14 age and body mass index (BMI) matched control subjects. OSAS patients and control subjects showed similar characteristics in FEV1, FEV1/FVC, FEF25–75, and FEF25–75/FVC ratios. Expiration reserve volume was significantly higher in the control group than in OSAS patients (p<0.01). Six patients exhibited extrathoracic airway obstruction while awake. Of these, three had also a sawtooth pattern in their flow–volume curves. The remaining nine patients had no extrathoracic airway obstruction and had lower apnea–hypopnea indexes (AHI) than the obstruction group (p<0.05). OSAS patients and age- and BMI-matched healthy controls had similar characteristics in terms of dysanapsis. In addition, there was no relation between the FEF25–75/FVC ratio and AHI, MinO2, and MeanO2. Extrathoracic airway obstruction may be a feature of only severe OSAS patients.

Influence of Intermittent Hypobaric Exposure on SOD and TBARS Levels in Trained Rats

Live high train low (LHTL) is a well-known training model for preparation of competitions. In this study, the thiobarbituric acid reacting substances (TBARS) levels and superoxide dismutase (SOD) activity were determined in heart, lung and muscle tissues of rats. They were intermittently exposed to hypobaric pressure of 523 mmHg, corresponding to an altitude of 3,000 m, and they performed swim training at sea level. Two groups of male rats were trained to swim for thirty minutes a day and 4 days a week, lasting 9 weeks. Two groups were exposed to hypobaria for 120 min a day and 4 days a week for 9 weeks in pressure cabin. In heart tissue, TBARS levels of normobaric trained (NbT) group was higher (P < 0.05) than those of the normobaric sedentary (control) group. TBARS levels of hypobaric trained (HbT) group was higher than those of the control and hypobaric sedentary (Hb) groups (P < 0.001; P < 0.01, respectively). TBARS levels of lung tissue of HbT group was also higher than those of the same groups (control; P < 0.01, Hb; P < 0.05, respectively). In muscle tissue, TBARS levels of HbT group was higher than those of the sedentary groups (control; P < 0.001, Hb; P < 0.05, respectively). SOD activity of heart tissue of HbT group was higher (P < 0.001) than that of the other groups. In lung tissue, SOD activity of control group was lower than that of the other groups (HbT; P < 0.001, NbT; P < 0.01, Hb; P < 0.01, respectively). In muscle tissue, SOD activity of HbT group was higher (P < 0.01) than that of the control group. The results of this study suggest that intermittent hypobaric exposure may augment exercise-induced oxidative stress in heart, lung and muscle of trained rats.

Aortic properties and atrial electrophysiology in the young and old football players

OBJECTIVE The purpose of this study was to investigate the differences between P wave dispersion, aortic elastic properties and transthoracic echocardiographic findings in the young and old football players compared to control groups in order to asses the influence of regular sportive activity on aortic distensibility and its potential effect on atrial electrophysiology. METHODS We recruited 42 young football players with a training history of many years. The control group was formed by 27 healthy sedentary men. Twenty-three healthy retired football players of a professional football club aged over 50 years were included in the study as old group and 18 subjects over 50 year old who did not perform regular exercise when they were young were included in the control group of old subjects. RESULTS The heart rate and ejection fraction were decreased in the young football players. There were no significant differences in the aortic elastic parameters and P wave dispersion between young football players and control group. But in old subjects with sustained participation in regular sportive activity, the significant difference of left ventricular dimension, wall thickness and systolic functions detected in the young group disappeared while increase in the left atrial diameter became significant. CONCLUSION Potential effect of aortic elastic properties which changes with age, on atrial electrophysiology through increasing P wave dispersion was shown.

An open-label, uncontrolled trial of the angiotensin-converting enzyme inhibitor cilazapril in the treatment of patients with chronic congestive heart failure

Abstract We assessed cilazapril, an angiotensin-converting enzyme (ACE) inhibitor, in the treatment of patients with chronic congestive heart failure. A single 2.5-mg dose of cilazapril was given to 20 patients with chronic congestive heart failure rated as New York Heart Association functional Class II for 15 days according to our protocol. Exercise capacity, breath-by-breath oxygen analysis, and echocardiographic variables were assessed before and after treatment. Cilazapril improved peak exercise time statistically significantly (7.36 ± 3.48 minutes vs 9.45 ± 5.17 minutes), but peak oxygen consumption (17.45 ± 4.19 mL/kg per minute vs 18.65 ± 3.70 mL/kg per minute) and peak heart rate (145.5 ± 23.7 beats/min vs 149.9 ± 27.1 beats/min) did not increase significantly. Anaerobic threshold time (3.31 ± 2.38 minutes vs 4.54 ± 2.99 minutes), anaerobic threshold oxygen consumption (11.03 ± 2.52 mL/kg per minute vs 12.77 ± 2.92 mL/kg per minute), and anaerobic threshold ratio (63.35 ± 7.59% vs 68.10 ± 7.67%) were statistically significant increased with cilazapril treatment without a significant change in anaerobic threshold heart rate (123.3 ± 20.4 beats/min vs 122.1 ± 20.7 beats/min). Cilazapril treatment also decreased statistically significantly the resting heart rate (91.4 ± 20.1 beats/min vs 85.3 ± 17.6 beats/min) during follow-up. No patient decompensated, and diuretic and digoxin doses were not changed during the study. No adverse effects of cilazapril were observed in any patient; however, the effect of cilazapril treatment was not detected on echocardiographic variables. We conclude that the ACE inhibitor cilazapril may be useful in the treatment of patients with chronic congestive heart failure.

GNB3 gene c.825C>T polymorphism and performance parameters in professional basketball players

UNLABELLED This study has been conducted to determine whether mean values of peak oxygen consumption (VO(2peak)), anaerobic test parameters and knee isokinetic test measurements are different among guanine nucleotide-binding protein, beta-3 (GNB3) genotype groups in a group of basketball players. METHODS Seventy-two healthy male (mean age, 22.9 ± 5.3 years) basketball players from the first division of national league participated. We studied GNB3 gene c.825C>T (rs5443) polymorphism, then divided the subjects into three groups as CC (n = 21), CT (n = 35), and TT (n =1 6). Mean VO(2peak), Wingate anaerobic test results, and isokinetic knee muscle strength measurements were compared among the genotype groups. RESULTS Mean VO(2peak) (60.1 ± 3.9; 56.7 ± 3.6; and 57.8 ± 3.3, respectively, p < 0.01), mean anaerobic minimum power (5.1 ± 0.4; 5.3 ± 0.5; and 4.4 v 0.5 W/kg, respectively, p < 0.001), mean anaerobic power drop (57.0 ± 6.2; 54.2 ± 6.9; and 62.9 ± 5.3%, respectively, p < 0.001) were significantly different among the study groups, CC, CT, and TT. Individuals with TT genotype exerted lower performance in terms of isokinetic knee muscle strength. CONCLUSION The presence of 825T-allele may impair athletic performance and may serve as a genetic marker of low capacity for athletic performance in male basketball players.