Diagnosis of exercise-induced bronchoconstriction: Eucapnic voluntary hyperpnoea challenges identify previously undiagnosed elite athletes with exercise-induced bronchoconstriction
Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK. British Journal of Sports Medicine
(Impact Factor: 5.03).
11/2011; 45(14):1126-31. DOI: 10.1136/bjsm.2010.072520
There is increasing evidence to suggest many elite athletes fail to recognise and report symptoms of exercise-induced bronchoconstriction (EIB), supporting the contention that athletes should be screened routinely for EIB.
To screen elite British athletes for EIB using eucapnic voluntary hyperpnoea (EVH).
228 elite athletes provided written informed consent and completed an EVH challenge with maximal flow volume loops measured at baseline and 3, 5, 10 and 15 min following EVH. A fall of 10% in forced expiratory volume in 1 s (FEV(1)) from baseline was deemed positive. Two-way analysis of variance was conducted to compare FEV(1) at baseline and maximal change following EVH between EVH-positive and EVH-negative athletes who did and did not report a previous diagnosis of EIB. Significance was assumed if p ≤0.05.
Following the EVH challenge 78 athletes (34%) demonstrated EVH positive. 57 out of the 78 (73%) athletes who demonstrated EVH positive did not have a previous diagnosis of EIB. 30 athletes reported a previous diagnosis of asthma, nine (30%) of whom demonstrated EVH negative. There was no significant difference between the magnitude of the fall in FEV(1) between athletes who reported a previous diagnosis of EIB and demonstrated EVH positive, and those with no previous diagnosis of EIB who demonstrated EVH positive (mean±SD; -21.6 ± 16.1% vs -17.1 ± 9.7%; p=0.07).
The high proportion of previously undiagnosed athletes who demonstrated EVH positive suggests that elite athletes should be screened routinely for EIB using a suitable bronchoprovocation challenge.
Available from: ipen.br
[Show abstract] [Hide abstract]
ABSTRACT: In the paper, the author presents a soil electrical model, based
on extensive measurements, from very low frequency to 1 MHz, and in a
physical criterion to validate measurement results. A methodology and a
computational procedure to determine the frequency and the transient
behavior of grounding systems, and the effects of such behavior on
safety of people and equipment are also presented. This procedure
considers, in correct way, soil electrical characteristics and the
treatment of electromagnetic behavior of grounding systems, including
propagation and attenuation in dissipative media, as it is the case of
Available from: Sergio Bonini
[Show abstract] [Hide abstract]
ABSTRACT: The asthmatic athlete has a long history in competitive sport in terms of success in performance and issues related to doping. Well documented are detailed objective tests used to evaluate the athlete with symptoms of asthma or airway hyperresponsiveness and the medical management. Initiated at the 2002 Salt Lake City Games, the International Olympic Committee's Independent Asthma Panel required testing to justify the use of inhaled beta-2 agonists (IBAs) in Olympic athletes and has provided valuable guidelines to the practicing physician. This program was educational and documented the variability in prevalence of asthma and/or airway hyperresponsiveness and IBA use between different sports and different countries. It provided a standard of care for the athlete with respiratory symptoms and led to the discovery that asthmatic Olympic athletes outperformed their peers at both Summer and Winter Olympic Games from 2002 to 2010. Changes to the World Anti-Doping Agency's Prohibited List in 2010 permitted the use of 2 IBA produced by the same pharmaceutical company. All others remain prohibited. However, there is no pharmacological difference between the permitted and prohibited IBAs. As a result of these changes, asthmatic athletes are being managed differently based on a World Anti-Doping Agency directive that has no foundation in pharmacological science or in clinical practice.
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.