Objectives The objective of this study was to evaluate the effects of inspiratory muscle training on inspiratory muscle strength, functional capacity and dyspnoea for patients with chronic heart failure, by summarising the published research on the effects of inspiratory muscle training. To identify the best mode of intervention in terms of: the load of maximal inspiratory pressure; the frequency of sessions; and the total duration of intervention. Methods A relevant literature research using the PubMed database, Cochrane and references of published studies, from 1998 to 2016, was conducted. Out of 65 randomised controlled trials, seven were considered as potentially relevant and were retrieved for detailed analysis. The methodological quality of each randomised controlled trial was rated using the physiotherapy evidence database scale. Results The included seven studies contained data on 203 patients. Typical training protocols involved training three, six or seven times per week with intensity ranging from 30% to 60% and for a duration ranging from 6 to 12 weeks. Maximal inspiratory pressure, walking distance and dyspnoea were improved in all studies and especially in those who set a load of 60% in their maximal inspiratory pressure, and have trained patients six times per week for 12 weeks. Conclusion In chronic heart failure patients, inspiratory muscle training results in a marked improvement in inspiratory muscle strength, walking distance and dyspnoea, notably when training patients at 60% of maximal inspiratory pressure, six times per week and for 12 weeks. A small number of studies and heterogeneity among studies may limit the findings of the present study.

These results show that 5 wk of exercise training produced changes in the contractile responses developed by isolated skeletal muscle cells. The combination of exercise training with ND treatment potentiated these effects, suggesting that there was some modification in the excitation-contraction coupling mechanism. ND treatment also produced a more potent effect in soleus than edl sedentary muscle.

The widely used organophosphorus pesticide chlorpyrifos (CPF) is often detected in food. CPF inhibits acetylcholinesterase and can modify muscle contractility and respiratory patterns. We studied the effects of chronic exposure to CPF on respiratory parameters and diaphragm contractility in 21- and 60-days old rats. Pregnant rats were exposed to oral CPF (1 or 5 mg/ kg /day: CPF-1 or CPF-5 groups vs vehicle: controls) from gestation onset up to weaning of the pups that were individually gavaged (CPF or vehicle) thereafter. Two developmental time points were studied: weaning (day 21) and adulthood (day 60). Whole-body plethysmography was used to score breathing patterns and apnea index during sleep. Then, diaphragm strips were dissected for the assessment of contractility and acetylcholinesterase activity. Results showed that the sleep apnea index was higher in CPF-exposed rats than in controls. In adult rats, the expiratory time and tidal volume were higher in CPF-exposed animals than in controls. At both ages, the diaphragm’s amplitude of contraction and fatigability index were higher in the CPF-5 group, due to lower acetylcholinesterase activity. We conclude that chronic exposure to CPF is associated with higher sleep apnea index and diaphragm contractility, and modifies respiratory patterns in sleeping juvenile and adult rats.

PurposeAcute gastroenteritis (AGE) is a major cause of morbidity and remains a major cause of hospitalization. Following the Syrian refugee crisis and insufficient clean water in the region, this study reviews the etiological and epidemiological data in Lebanon.MethodsWe prospectively analyzed demographic, clinical and routine laboratory data of 198 children from the age of 1 month to 10 years old who were admitted with the diagnosis of AGE to a private tertiary care hospital located in the district of Nabatieh in south Lebanon.ResultsMales had a higher incidence of AGE (57.1%). Pathogens were detected in 57.6% (n=114) of admitted patients, among them single pathogens were found in 51.0% (n=101) of cases that consisted of: Entamoeba histolytica 26.3% (n=52), rotavirus 18.7% (n=37), adenovirus 6.1% (n=12) and mixed co-pathogens found in 6.6% (n=13). Breast-fed children were significantly less prone to rotavirus (p=0.041). Moreover, children who had received the rotavirus vaccine were significantly less prone to rotavirus (p=0.032).ConclusionOur findings highlight the high prevalence of E. histolytica infection as the major cause of pediatric gastroenteritis in hospitalized children, during the summer period likely reflecting the insanitary water supplies and lack of hygiene. Moreover the 42.4% of unidentified causative pathogens should prompt us to widen our diagnostic laboratory arsenal by adopting new diagnostic technologies.