Exercise chronic

Congestive heart failure Pulmonary embolism Pulmonary hypertension or emphysema Strenuous exercise Chronic renal insufficiency... 

Problems in water and salt nutrition can occur with severe and prolonged diarrhea or vomiting and with prolonged exercise. Chronic changes in salt nutrition can change blood pressure and influence the course of cardiovascular disease. These nutritional concerns are addressed after first discussing normal plasma levels of sodium and potassium. 

Decrements in vigilance (i.e., ability to detect small changes in one s environment that occur at unpredictable times) decreased exercise performance in both healthy persons and those with chronic obstructive pulmonary disease... 

Cell BR, Cote CG, Marin JM et al (2004) The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. New Engl J Med 350 1005-1012... 

Intrinsic asthma (also called nonallergic asthma and caused by chronic or recurrent respiratory infections, emotional upset, and exercise)... 

Sympathomimetics (drugs that mimic the sympathetic nervous system) are used primarily to treat reversible airway obstruction caused by bronchospasm associated with acute and chronic bronchial asthma, exercise-induced bronchospasm, bronchitis, emphysema, bronchiectasis (abnormal condition of the bronchial tree), or other obstructive pulmonary diseases. 

Pawlowska D, Moniuszko-Jakoniuk J, Soltys M. 1985b. The effect of chronic physical exercise on the activity of hydrolytic enzymes in acute poisoning with parathion-methyl in rats. Pol J Pharmacol Pharm 37 639-646. 

Hypoperfusion of skeletal muscles leads to fatigue, weakness, and exercise intolerance. Decreased perfusion of the central nervous system (CNS) is related to confusion, hallucinations, insomnia, and lethargy. Peripheral vasoconstriction due to SNS activity causes pallor, cool extremities, and cyanosis of the digits. Tachycardia is also common in these patients and may reflect increased SNS activity. Patients will often exhibit polyuria and nocturia. Polyuria is a result of increased release of natriuretic peptides caused by volume overload. Nocturia occurs due to increased renal perfusion as a consequence of reduced SNS renal vasoconstrictive effects at night. In chronic severe HF, unintentional weight loss can occur which leads to a syndrome of cardiac cachexia. This results from several factors, including loss of appetite, malabsorption due to gastrointestinal edema, elevated metabolic rate, and elevated levels of proinflammatory cytokines. 

Exercise facilitates both weight loss and blood pressure reduction. In addition, regular exercise improves functional capacity and symptoms in chronic stable angina.1 Once drug therapy for IHD is instituted, patients should be encouraged... 

Therapy for chronic asthma is directed at suppressing the underlying inflammatory response and normalizing pulmonary function. The goals of treatment for chronic asthma are to (1) prevent chronic and troublesome symptoms (2) maintain normal or near normal pulmonary function (3) maintain normal activity levels, including exercise and other physical activities (4) prevent recurrent exacerbations of asthma and minimize the need for emergency department visits or hospitalizations (5) provide optimal pharmacotherapy with minimal or no adverse effects and (6) meet patients and families expectations of and satisfaction with asthma care.1... 

Pulmonary symptoms may include chronic cough, sputum production, and decreased exercise tolerance. 

The musculoskeletal system consists of the muscles, bones, joints, tendons, and ligaments. Disorders related to the musculoskeletal system often are classified by etiology. Acute soft-tissue injuries include strains and sprains of muscles and ligaments. Repeated movements in sports, exercise, work, or activities of daily living may lead to repetitive strain injury, where cumulative damage occurs to the muscles, ligaments, or tendons.1-3 While tendonitis and bursitis can arise from acute injury, more commonly these conditions occur as a result of chronic stress.3,4 Other forms of chronic musculoskeletal pain, such as pain from rheumatoid arthritis (see Chap. 54) or osteoarthritis (see Chap. 55), are discussed elsewhere in this text. 

Bronchial asthma is defined as a chronic inflammatory disease of the lungs it affects an estimated 9 to 12 million individuals in the U.S. Furthermore, its prevalence has been increasing in recent years. Asthma is characterized by reversible airway obstruction (in particular, bronchospasm), airway inflammation, and increased airway responsiveness to a variety of bronchoactive stimuli. Many factors may induce an asthmatic attack, including allergens respiratory infections hyperventilation cold air exercise various drugs and chemicals emotional upset and airborne pollutants (smog, cigarette smoke). 

Beta-enolase deficiency (type XIII, Fig. 42-1) has been identified in a 47-year-old man with late-onset but rapidly progressive exercise intolerance and exercise-triggered myalgia. He did not complain of cramps, never experienced pigmenturia, but had chronically elevated serum CK. The patient was a compound heterozygote for two mutations in the EN03 gene, which is located on chromosome 17 [1],... 

Ranolazine is indicated for the treatment of chronic angina. Based on controlled trials, the improvement in exercise time is a modest increase of 15 to about 45 seconds compared with placebo. In a large ACS trial, ranolazine reduced recurrent ischemia but did not improve the primary efficacy composite end point of cardiovascular death, MI, or recurrent ischemia. 

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