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Biomedical subjects

P Wittels

Publications and source records attributed to P Wittels.

11 recordsLinked to original sources

Vascular endothelial growth factor in exercising humans under different environmental conditions.

It was the aim of this study to investigate the time course of changes in the serum concentrations of vascular endothelial growth factor (VEGF) during a regular survival training programme combined with food and fluid deprivation and during a high altitude marathon run. We studied soldiers of the Austrian Special Forces performing survival training at sea-level and marathon runners of the Posta Atletica who crossed the border between Chile and Argentina at altitudes up to 4722 m. Baseline data collected before the 1-week of survival training showed that the soldiers had normal VEGF [n = 8, 246.7 (SD 118.5) pg.ml(-1)] serum concentrations which remained unchanged during the course of the study. Before the high altitude marathon the subjects showed normal VEGF serum concentrations [178 (SD 84.5) pg.ml(-1)]. After the run VEGF concentrations were found to be significantly decreased [41.0 (SD 41.6) pg ml(-1), P < 0.01]. It was concluded that prolonged physical stress during normobaric-normoxia did not alter the VEGF concentrations whereas during severe hypobaric-hypoxia decreased VEGF serum concentrations were measured, at least temporarily, after prolonged physical exercise which might have been due to changes in production, release, removal and/or binding of circulating VEGF.

Adolescent↗

[Reduced lung function parameters after physical exertion in Austrian Alps in ozone concentrations below the legal warning limit].

The ambient ozone concentration has increased greatly over the past decades, which may lead to environmental health problems, especially during the summer. WHO guidelines recommend an 8 hour mean value of < or = 60 ppb ozone without health risk. The aim of the present study was to investigate if elevated zone concentrations at moderate altitudes in the Austrian Alps, characteristic of the situation in the summer months, influence pulmonary function after physical exercise. 24 male non-smokers (mean age 26.7 +/- 4 years) were investigated in the Tyrol (Pitztal) at a mean sea level of 2434 m. During a mountain-guide course lasting for 6 days the subjects were physically active all day long. Spirometry was performed in the morning and in the evening after 8 h of exercise. Ozone and PM10 concentrations were measured on site. The ozone 24 hour mean values ranged between 53 and 71 ppb. A mean decrease of 5.3% (p < 0.00001) was measured in forced vital capacity (FVC) and forced expiratory volume (FEV1) at t3,m in immediately after the highest ozone 24 hour mean value had been registered (71 ppb). A clinically relevant decrease of FVC and FEV1 > 10% was observed at t3,m in 35% of the subjects. However, a linear dependence of lung function changes on the ozone 8 hour mean values was demonstrable for all measuring points only in 10% of these subjects. In 90% of the subjects with a decrease of lung function parameters > 10%, this reduction was at least not monocausally linked to ozone.

Adult↗

Fluid regulation during prolonged physical strain with water and food deprivation in healthy, trained men.

The aim of this study was to investigate fluidregulating mechanisms, with special regard to the role of plasma proteins in the control of plasma volume (PV), and the role of the superficial tissues as a water storage organ of the body during prolonged physical strain. 29 male subjects (mean age 22.2 +/- 2.8 years) were studied during a 5 day period of survival training with multifactorial strain including restricted water intake (11 H2O.day-1) and food intake (628 kJ.day-1) additionally to physical exercise and sleep deprivation (20 h within 5 days). Under field conditions the heart rate was monitored continuously, and body mass, body composition, thickness of the shell tissues, and blood parameters were measured at (T1), after 72 h (T2), after 120 h (T3) and in the recovery period after 48 h (T4) and 72 h (T5). The estimated energy expenditure was approximately 24,000 kJ.day-1. The mean decrease of body mass was 6.77 kg (9.5%) at T3 (p < 0.001), 0.95 kg (1.3%) at T4 (p < 0.05) and 0.68 kg (0.9%) at T5 (n.s.). A reduction of total body water of 3.8 1 was estimated at T3. Serum creatinine ([Cr]) was raised at T3 by 18.5% (p < 0.0001). No relationship was found between [Cr] and other parameters. The PV decreased by 3.7% (p < 0.0001) at T2, increased by 1.6% (p < 0.0001) at T3 and was not different to baseline at T4 (+0.2%; n.s.). Total protein concentration ([TP]) increased at T2 (11.7%; p < 0.0001) and T3 (2.6%; p < 0.01), and decreased (p < 0.0001) at T4 (8.2%) and T5 (5.7%). Plasma proteins shifted into the intravascular space at T2 and T3 and moved out of the intravascular space at T4 and T5. This gives support to the hypothesis that one of the counterregulatory mechanisms maintaining PV during prolonged exercise is provided by protein shifts from the extravascular into the intravascular space. Our data provide evidence that this mechanism assists PV homeostasis efficiently over a period of 120 h with multifactorial strain, even under conditions with a fluid loss of almost 8% of the total body water.

Adult↗

Erythropoietin in 29 men during and after prolonged physical stress combined with food and fluid deprivation.

The study investigated the influence of prolonged physical stress during survival training with food and fluid deprivation on the serum concentrations of erythropoietin (EPO). A group of 29 male subjects [mean age 22.2 (SD 2.8) years, height 1.78 (SD 0.06) m, and body mass (m(b)) 73.5 (SD 8.6) kg] were studied for 5 days of multifactorial stress including restricted water intake (11 H2O. day(-1)) and food intake (628 kJ. day(-1)) combined with physical exercise (estimated energy expenditure approximately 24000 kJ.day(-1)) and sleep deprivation (20 h within 5 days). Blood samples were taken before (T1), after 72 h (T2) and 120 h (T3) of physical stress, and after 48 h, (T4) and 72 h (T5) of recovery. The samples were analysed for EPO, and concentrations of serum iron (Fe), haptoglobin (Hapto), transferrin (Trans), ferritin (Fer), haemoglobin (Hb) and packed cell volume (PCV). The m(b) had decreased by 6.77 kg at T3 (P <0.01) and 0.68 kg at T5. The EPO and Hapto decreased during the survival training (P <0.01) and increased during the recovery period (P <0.01). The Fe increased during the survival training (P <0.01) and remained above the control concentrations during recovery (P <0.01). The Hapto decreased during the survival training (P <0.01) and remained below control concentration at T4 and T5 (P <0.01). The Trans decreased continuously over the week (P <0.01). The Fer increased during the survival training (P <0.01) and returned to control concentration at T5. The Hb increased from T1 to T2 (P <0.01) and had decreased significantly at T5 (P <0.01). The PCV increased from T1 to T2 (P <0.01) and remained below control levels afterwards (P <0.01). From our study it was concluded that, in humans, prolonged physical stress with food and fluid deprivation induces a marked EPO decrease, which is followed by a rapid increase during recovery to restore the reduced O2 transport capacity.

Adult↗

Fluid distribution and tissue thickness changes in 29 men during 1 week at moderate altitude (2,315 m).

To quantify fluid distribution at a moderate altitude (2,315 m) 29 male subjects were studied with respect to tissue thickness changes [front (forehead), sternum, tibia], changes of total body water, changes of plasma volume, total protein concentrations (TPC), colloid osmotic pressure (COP), and electrolytes. Tissue thickness at the forehead showed a significant increase from 4.14 mm to 4.41 mm 48 h after ascent to the Rudolfshuette (2,315 m) (P < 0.05). At 96 h after ascent the tissue thickness at the tibia was decreased to 1.33 mm compared to the control value of 1.59 mm (P < 0.01). Body mass increased from 75.5 kg (control) to 76.2 kg on the last day (P < 0.05) and body water from 44.21 to 45.01 during the week (P < 0.01). The accumulation fluid in the upper part of the body was paralleled by a decrease in TPC and COP. At 48 h after the ascent COP dropped from 29.5 mmHg to 27.5 mmHg (P < 0.01). After 96 h at moderate altitude COP was still significantly decreased compared to the control level. At 1.5 h after the return from the Rudolf-shuette in Saalfelden (744 m) COP was back to the control values. The TPC also showed an initial drop from 7.75 g.dl-1 to 7.48 g.dl-1 after 48 h at altitude and remained below the control value during the whole week (P < 0.01). It seems from our study that even with exposure to moderate altitude measurable fluid shifts to the upper part of the body occurred which were detected by our ultrasound method.

Acclimatization↗

[Computer-assisted evaluation of bicycle ergometry for determining level of endurance training in physical fitness].

Recent studies have provided evidence of the importance of aerobic endurance training as an independent factor with regard to reducing morbidity and mortality from cardiovascular diseases. Clinical routine shows that test methods and training recommendations are often not specific enough for efficient, yet safe exercise. Software is presented which allows cycle ergometry to be used according to standard criteria in clinical practice, with special attention to the requirements for training with health benefit. Technical requirements: 1. Cycle ergometer with the possibility of increasing exercise intensity by Watt (W) increments; 2. ECG or other device for accurate pulse monitoring; 3. IBM-compatible PC and printer. Based upon the input of data on birth date, sex, height, weight, and heart rate (HR) at rest the programme calculates body surface area, the reference value of physical work capacity of matching subjects and the expected maximal HR (HRmax,exp) and HRmax,exp x 0.95. After the test, input of HR at exhaustion (HRmax), maximum achieved W-increment and time cycled at this intensity in seconds provides various parameters of the individual work capacity. The maximal work performance W (Wmax) is calculated. This value is used to provide further calculations of Wmax.kg-1, VO2max.kg-1 and the maximal work performance as a percentage of the normal value (LF%). The software provides an individual training plan with incremental extension of training time and a prescription for heart rate controlled intensity of endurance training based upon medically accepted training principles. The software enables a standard test to be used and recommends medically efficient and secure quality and quantity guidelines for endurance training.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Aerobic fitness and sympatho-adrenal response to short-term psycho-emotional stress under field conditions.

A possible relationship between aerobic fitness (AF), measured by maximal cycle ergometry (CE) and sympatho-adrenal response to acute, short lasting psycho-emotional stress was investigated by monitoring heart rate (fc) and excretion of catecholamines. The activation of the sympatho-adrenal system was characterised by the noradrenaline: adrenaline ratio. A group of 11 healthy men [22.8 (SD 2.52) years] lived under identical environmental conditions; their mean maximal oxygen uptake (VO2max) was 47.1 (SD 3.9) ml.min-1.kg-1. After the physiological and psychological laboratory tests had been completed the fc of the subjects was monitored continuously during the "guerilla slide" and "parachute jump by night", two emotionally stressful military tasks. Maximal fc (fc, max) attained during these events was 84.5% and 83% of fc, max during CE (fc, max, CE), respectively. A significant relationship (r = -0.92, P < 0.0002) between fc, max reached during the stressful tasks and VO2max was found only for the guerilla slide, which was preceded by physical strain, sleep deprivation and energy deficit. One subject with some prior experience in parachuting showed the lowest fc response and the lowest sympatho-adrenal activation in both events, independent of the degree of AF. In conclusion, AF was found to influence the sympatho-adrenal and fc response to acute, short-lasting emotional stress when the stressful event was aggravated by preceding physical strain, the magnitude of the stress response depending largely on individual experience and effective mechanisms for coping with specific stimuli.

Adrenal Glands↗

[Hemofiltration and the neurohumoral system in patients with severe heart failure].

6 fluid overloaded patients with congestive heart failure, NYHA classification IV, resistant to drug therapy, were treated by pump driven venovenous hemofiltration. The sympathetic nervous system measured by plasma norepinephrine concentration was stimulated in all patients. 4 of 6 patients had a markedly enhanced plasma renin activity. Between 7 and 20 l of fluid were removed by hemofiltration. The expected increase of plasma norepinephrine did not occur in 4 out of 6 patients. The improvement of cardiac pump function by hemofiltration could be an explanation for this apparent paradoxical regulation. Patients who had almost a normal plasma renin activity prior to hemofiltration showed a marked increase after the procedure. In patients with extremely high levels of plasma renin activity we noted a decrease after hemofiltration. Almost in every patient with a serum sodium concentration lower or equal 132 mmol/l the plasma renin activity was markedly elevated. Patients with normal serum sodium concentrations exhibited only slightly elevated plasma renin activity. Therefore, a hyponatremia in patients with heart failure can be used as a marker for high plasma renin activity. All patients had a significant improvement of the clinical state after hemofiltration. 3 patients, however, showed deterioration within a few weeks, due to the severity of the disease. Their plasma norepinephrine levels remained high or had a tendency to increase.

Adult↗

[Peripartum cardiomyopathy--a case report].

Peripartum cardiomyopathy (PPCM), a disorder of heart muscle, presents with the onset of cardiac failure in the last month of pregnancy or in the first 5 postpartum months. A patient with foudroyant clinical course is presented. Despite detailed clinical investigations and postmortem examination no aetiological factor was found. Diagnostic and therapeutic possibilities are discussed.

Adult↗

[Hemofiltration in chronic heart failure].

30 patients with severe congestive heart failure (NYHA IV) unresponsive to medical management were treated by continuous hemofiltration (CHF). 57% of patients received arteriovenous CHF and 43% of patients venovenous, machine assisted CHF over 95 +/- 31 hours. A reduction of body edemas was achieved. The removal of body fluid by CHF between 2 and 40 kg led to a reduction of body edemas and short-term clinical improvement. Furthermore CHF treatment induced hemodynamic improvement with a reduction of central venous pressure (18 +/- 6 cm H2O pre CHF vs 8 +/- 4 cm H2O post CHF p less than 0.01) and a reduction of left ventricular filling pressure (22 +/- 6 mm Hg vs 14 +/- 5 mm Hg, p less than 0.01), while the left ventricular ejection fraction remained unchanged. Patients with low serum sodium levels (less than 132 mval/l) benefited most. While 28/30 of patients has short-term clinical improvement between 2 and 8 weeks, 38% of patients had long-term benefits.

Adult↗