[The coronary rehabilitation program at the Laval City of Health].
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Academic Medical Centers↗
Biomedical subjects
J Charlebois
Publications and source records attributed to J Charlebois.
Skeletal muscle and cardiac changes with training in patients with angina pectoris.
Cardiovascular and skeletal muscle adaptations were studied before and after 6 mo of physical training in patients with coronary artery disease and exertional angina pectoris. Symptom-limited exercise capacity increased by 41% (470 +/- 30 to 665 +/- 35 kg.m.min-1; n = 29, P less than 0.001) with training as did skeletal muscle succinate dehydrogenase activity (1.75 +/- 0.24 to 3.31 +/- 0.24 IU; n = 23, P less than 0.001) and the areas of muscle fibers (type I from 43.6 +/- 3.3 to 54.4 +/- 3.3 micrometers 2 X 10(2); n = 21, P less than 0.05 and type II from 43.9 +/- 2.4 to 57.2 +/- 5.1 micrometers 2 X 10(2); P less than 0.01). At the same submaximal exercise intensity (mean 355 +/- 100 km.m.min-1), plasma catecholamines (1.31 +/- 0.14 to 1.07 +/- 0.09 ng.ml-1; n = 13, P less than 0.05), heart rate (115 +/- 3 to 97 +/- 3 beats/min; n = 29, P less than 0.001), and systolic blood pressure (171 +/- 4 to 143 +2- 4 mmHg; n = 29, P less than 0.001) were significantly reduced after training. Maximal coronary sinus blood flow (192 +/- 10 to 208 +/- 9 ml.min-1; n = 29, P less than 0.05) and left ventricular oxygen consumption (23.2 +/- 1.5 to 25.8 +/- 1.6 ml.min-1; n = 24, P less than 0.05) were increased by 8 and 11%, respectively, after training. The improvement in exercise capacity with training in patients with exercise is secondary to a reduction in myocardial oxygen requirements during subangina levels of exercise and partly to a small increase in maximal myocardial oxygen consumption. The skeletal muscle adaptations with training were not related to other indices of training such as the reduced exercise heart rate or increased symptom-limited exercise capacity.
Adult↗
Using a breastfeeding prevalence survey to identify a population for targeted programs.
Often, efforts to improve overall population health require identifying and targeting programs to specific high-risk populations. Breastfeeding is an example. In order to determine initiation and duration rates among various groups in the City of Toronto, a random sample of 434 mothers with infants at four months of age was surveyed to determine the prevalence of breastfeeding and major impacts on its duration. The study found that, overall, 83% of mothers initiated breastfeeding at birth. The greatest rate of decline occurred during the first month. At four months postpartum, 57% of mothers continued to breastfeed, including 35% who were exclusively breastfeeding and 22% who were supplementing breast milk with formula. Breastfeeding duration was related to a number of factors, including information and support, parity, education, use of formula supplements and country of birth. Specific groups are identified for targeted programs, and a number of strategies are proposed.
Adult↗