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The goal of the work was to study a prevalence of juvenile systemic hypertension among 15-16 years old adolescents of Tbilisi, its clinical characteristics and several indices of mental capacity. In the result of an analysis of 378 adolescents' blood pressure records only 6 (1.6%) had high normal values and 32 (8,46%) revealed juvenile systemic hypertension. Four youths from 6 with high normal values refused to participate in a further investigation. For this reason the study was continued only in 32 youths with juvenile systemic hypertension. In the contingent noted 6 (18,75%) had overweight, 9 (28,12%) had hereditary predisposition, 15 (46,9%) revealed excessive use of salt, 3 (9,4%) had moderate consumption of alcohol and 7 (21,9%) noted insufficient physical activity. Juvenile systemic hypertension in youth was predominantly asymptomatic, only 9 (28,12%) had mild headache in the evening, 12 (37,5%) had light fatigue and 5 (15,6%) weak dizziness. Fourteen youths noted diminished work-status and being behind in learning process. In the persons with juvenile systemic hypertension diminution of the attention concentration was observed during a fulfilment of a simple sensor and motor task in condition of monotonous work (increment of answers missed up to 13+/-12%). A psycho-emotional loading test has proved the fact of mental capacity lowering within the persons with juvenile systemic hypertension that is expressed in the increment of errors made up to 12+/-3,1% and answers missed up to 11+/-2,3%. Our investigations confirm the reasonability of blood pressure monitoring among adolescents for the early detection of the juvenile systemic hypertension and the conduction of an opportune preventive measures for avoiding of cardiovascular diseases in a mature age.
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PMID:[Clinical characteristics of juvenile systemic hypertension in the population of Tbilisi]. 1670 37

The development of body weight gain and lipodystrophy due to antiretroviral therapy may lead to disturbances in sleep, particularly the obstructive sleep apnoea (OSA) syndrome. A retrospective review of the medical records of consecutively identified HIV-infected subjects who were diagnosed with OSA by overnight polysomnography between January 1, 2003 and December 31, 2004 was performed. Twelve HIV-infected subjects with OSA confirmed by polysomnography (total apnoea/hypopnoea index > or = 5) were identified. Daytime somnolence, fatigue, and snoring were the most common symptoms identified. Eleven (92%) subjects were overweight/obese, and seven (58%) had lipodystrophy. Eleven (92%) had a neck size > or =40.0 cm. Increased neck circumference, overweight or obese body mass index, and lipodystrophy are therefore potential risk factors for OSA among HIV patients. Clinicians caring for HIV patients with these characteristics should inquire about daytime somnolence, fatigue, and snoring and consider evaluation for a sleep-related disorder such as OSA. Overnight polysomnography can aid in the diagnosis of sleep disturbances.
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PMID:Obstructive sleep apnoea among HIV patients. 1694 53

The number of food products containing extra or reduced levels of specific ingredients (e.g. extra calcium) that bring particular health benefits (e.g. stronger bones) is still increasing. Nutrition- and health-related (NH) claims promoting these ingredient levels and their health benefit differ in terms of the (legal) strength with which the claim is brought forward and the specific wording of the claim, both of which may differ between countries. Using a large-scale cross-national internet-based survey in Italy (n=1566), Germany (n=1620), UK (n=1560) and US (n=1621), the purpose of the study described here is to investigate consumer perceptions of NH food product claims, across different countries. NH claims are systematically varied as a function of six health benefits (cardiovascular disease, stress, infections, fatigue, overweight and concentration) and five claim types (content, structure-function, product, disease-risk reduction and marketing claim). The general results indicate that consumer perceptions differ substantially by country and benefit being claimed but much less by the claim type. Implications of these findings are being discussed.
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PMID:Consumer perceptions of nutrition and health claims. 1715 58

Myotonic dystrophy (MD) is the commonest adult muscular dystrophy and is associated with respiratory muscle weakness. The role of screening sleep studies is unclear in MD. We prospectively evaluated polysomnography/overnight oximetry in a group of MD patients and related this to the daytime respiratory function in an attempt to evaluate the usefulness of screening sleep studies. Twenty-five patients with type I MD [15 males; mean age (SD) 40.0 (10.9) years] who had at least one symptom suggestive of nocturnal hypoventilation were included in the study. We performed spirometry, maximal inspiratory and expiratory mouth pressures, sniff nasal inspiratory pressure, arterial blood gases and polysomnography or overnight oximetry. Excessive tiredness and sleepiness were the most common presenting symptoms. Prevalence of sleep related breathing disorder (SRBD) was 36%. FVC was found to be normal in 33% of subjects with significant SRBD. Mouth pressures were reduced more than FVC, even in patients with normal overnight oxygen saturation. Of all the daytime measures, FVC correlated best with arterial carbon dioxide tension (r = -0.7). Sleep studies were useful to identify a small group of myotonic dystrophy patients (12%, three out of 25 in our series) with SRBD that would have been missed with routine daytime assessments. Targeted sleep monitoring in patients who are older, with multiple symptoms suggestive of SRBD, especially if they are overweight seems to be the best way to utilize the existing resources. Home unattended oximetry was well tolerated and offers a practical screening tool in this challenging patient group where excess daytime sleepiness is often due to causes other than SRBD.
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PMID:Assessment of sleep studies in myotonic dystrophy. 1741 48

Children and adolescents with physical and cognitive disabilities have a higher prevalence of overweight compared to their non-disabled peers. This health risk can lead to a greater number of obesity-related secondary conditions (e.g., fatigue, pain, deconditioning, social isolation, difficulty performing activities of daily living) and can impose significant personal and economic hardship on the child and family. Effective strategies for reducing the risk of overweight/obesity in adolescents with disabilities must begin with greater awareness of the behavioral and environmental antecedents that lead to higher rates of obesity in this underserved segment of the youth population. Research on interventions to reduce obesity among adolescents with disabilities is an important area of future research for public health scientists. A range of interventions will be necessary to overcome the many barriers that youth with disabilities experience in achieving and maintaining a healthy weight.
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PMID:Obesity and secondary conditions in adolescents with disabilities: addressing the needs of an underserved population. 1770 91

Ketogenic diets have been associated with reductions in free-living physical activity, a response that can be counterproductive in individuals trying to lose weight. To explore whether popular low-carbohydrate diets might impact the desire to exercise by raising blood ketone concentrations, fatigue and perceived effort during exercise were compared in untrained, overweight adults adhering to a ketogenic low-carbohydrate diet or to a control diet low in carbohydrate, but not ketogenic (5%, 65%, and 30% or 40%, 30%, and 30% of energy from carbohydrate, fat, and protein, respectively). In this prospective, randomized, 2-week pilot study, all meals and snacks were provided to subjects, and energy intake was strictly controlled to provide approximately 70% of that needed for weight maintenance. At baseline and at the end of week 2, exercise testing was conducted in fasting participants. Weight loss and the reductions in fat mass did not differ by group during the trial. At week 2, blood beta-hydroxybutyrate concentrations were 3.6-fold greater for the ketogenic vs nonketogenic group (P=0.018) and correlated significantly with perceived exercise effort (r2=0.22, P=0.049). Blood beta-hydroxybutyrate was also significantly correlated to feelings of "fatigue" (r=0.458, P=0.049) and to "total mood disturbance" (r=0.551, P=0.015) while exercising. These pilot data indicate that ketogenic, low-carbohydrate diets enhance fatigability and can reduce the desire to exercise in free-living individuals.
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PMID:Blood ketones are directly related to fatigue and perceived effort during exercise in overweight adults adhering to low-carbohydrate diets for weight loss: a pilot study. 1790 39

Post-stroke objective or subjective fatigue occurs in around 50% of patients and is frequent (30%) even after minor strokes. It can last more than one year after the event, and is characterised by a different quality from usual fatigue and good response to rest. Associated risk factors include age, single patients, female, disability, depression, attentional impairment and sometimes posterior strokes, but also inactivity, overweight, alcohol and sleep apnoea syndrome. There are few therapy studies, but treatment may include low-intensity training, cognitive therapy, treatment of associated depression, wakefulness-promoting agents like modafinil, correction of risk factors and adaptation of activities.
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PMID:Frequency, characterisation and therapies of fatigue after stroke. 1869 May 6

Validated target heart rate (THR) zones for exercise prescription for overweight and obese pregnant women have not been developed. The purposes of this study were to determine if heart rate reserve (HRreserve) is best described by aerobic capacity at peak exercise or by aerobic capacity reserve (VO2 reserve) and to develop and validate THR zones for light-intensity exercise (20%-39%VO2 reserve) in sedentary overweight and obese pregnant women. One hundred six women between 16 and 20 weeks gestation with medical clearance performed a progressive treadmill test to volitional fatigue (peak). Data from every 4th subject were used for cross-validation. Two linear regression equations were performed for each subject, then pooled to obtain mean group values (+/- SD): %HRreserve vs. %VO2 peak and %HRreserve vs. %VO2 reserve. THR zones equivalent to 20%-39%VO2 reserve were developed and validated based on the strongest relationship. %HRreserve had a stronger linear relationship with %VO2 reserve (y = 1.046x -7.561; R2 = 0.741) than %VO2 peak (y = 1.259x -28.795; R2 = 0.604). Validated THR ranges for sedentary overweight and obese pregnant women are 102-124 beats.min-1 (20-29 years of age) and 101-120 beats.min-1 (30-39 years of age), representing an exercise intensity of 20%-39%VO2 reserve as recommended by the American College of Sports Medicine for previously sedentary pregnant women. Overweight and obese women who are medically prescreened can exercise during pregnancy within our validated THR zones. The relationship between HR and VO2 remains strong, but the two are not equivalent in this population group.
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PMID:Development and validation of exercise target heart rate zones for overweight and obese pregnant women. 1892 74

Over half of all Australians are classified as overweight or obese and this is increasing by 1% of the population per year. Obesity is linked with a range of health ailments including type 2 diabetes, heart diseases and some cancers. At a population level it is well accepted that obesity is a result of the increasing use of modern technology, resulting in decreased energy expenditure, in combination with easily available high energy density foods, the "obesogenic environment". In the modern environment, there are two major areas of management to assist the overweight and obese. Both include a change in lifestyle. Future strategies in weight management should include reduction in energy density and increase in daily physical activity.
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PMID:Dealing with obesity: an Australian perspective. 1892 39

Although obesity is increasing in prevalence, relatively little attention has been given to its impact on outcomes in patients with chronic obstructive pulmonary disease (COPD) completing pulmonary rehabilitation. We conducted a retrospective chart review of 114 patients with COPD who completed outpatient pulmonary rehabilitation at our center. Body habitus categories were determined based on body mass index (BMI). Underweight patients (BMIA <A 21A kg/m(2)) were excluded from the analysis. Normal weight and overweight patients were classified as non-obese. Obese patients (BMIA >30A kg/m(2)) were compared with non-obese patients in the following areas: forced expiratory volume in 1A s (FEV(1)) percent predicted, the 6-min walk distance (6MWD), health status, the number of unsupported arm lifts per minute, and functional performance. Health status was determined using the Self-Reported Chronic Respiratory Questionnaire (CRQ-SR), which has dimensions of dyspnea, fatigue, emotion, and mastery. Functional performance was determined using the Pulmonary Functional Status Scale Daily Activities subscore. Compared with non-obese patients, obese patients had a higher FEV(1) percent-predicted (44A +/-A 15% vs 52A +/-A 16%; PA =A 0.01), yet had lower 6MWD (269A +/-A 11 vs 203A +/-A 13; PA =A 0.0002), lower functional status, and greater fatigue at initial evaluation. However, the two groups had similar walk-work, which adjusts for differences in weight. Despite the baseline differences, both groups improved similarly following pulmonary rehabilitation (change in 6MWD was 52A +/-A 7A m in the non-obese patients versus 47A +/-A 9 in the obese patients; PA =A 0.65). Our study suggests that obese COPD patients are referred to pulmonary rehabilitation at an earlier spirometric stage of their disease, but have a poorer exercise performance, a greater degree of functional impairment and greater fatigue levels. This is probably, largely because of the effect of an increased weight burden. However, obesity did not seem to adversely affect the pulmonary rehabilitation outcomes.
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PMID:The influence of obesity on pulmonary rehabilitation outcomes in patients with COPD. 1902 31


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