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Article ; Online: Pulmonary blood volume measured by

Hartmann, Jacob Peter / Lassen, Martin Lyngby / Mohammad, Milan / Iepsen, Ulrik Winning / Mortensen, Jann / Hasbak, Philip / Berg, Ronan M G

Journal of applied physiology (Bethesda, Md. : 1985)

2024

Abstract: In patients with chronic obstructive pulmonary disease (COPD), pulmonary vascular dysfunction and destruction are observable before the onset of detectable emphysema, but it is unknown whether this is associated with central hypovolemia. We investigated ... ...

Abstract	In patients with chronic obstructive pulmonary disease (COPD), pulmonary vascular dysfunction and destruction are observable before the onset of detectable emphysema, but it is unknown whether this is associated with central hypovolemia. We investigated if COPD patients have reduced pulmonary blood volume (PBV) evaluated by
Language	English
Publishing date	2024-04-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	219139-8
ISSN	1522-1601 ; 0021-8987 ; 0161-7567 ; 8750-7587
ISSN (online)	1522-1601
ISSN	0021-8987 ; 0161-7567 ; 8750-7587
DOI	10.1152/japplphysiol.00058.2024
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Article ; Online: The role of T-type calcium channels in elderly human vascular function: A pilot randomized controlled trial.

Iepsen, Ulrik Winning / Hjortdal, Andreas R / Thuesen, Anne D / Finsen, Stine H / Hansen, Pernille B L / Mortensen, Stefan P

Experimental physiology

2024 Volume 109, Issue 5, Page(s) 779–790

Abstract: Endothelial dysfunction develops with age and may precede cardiovascular disease. Animal data suggest that T-type calcium channels play an important role in endothelial function, but data from humans are lacking. This study included 15 healthy, sedentary, ...

Abstract	Endothelial dysfunction develops with age and may precede cardiovascular disease. Animal data suggest that T-type calcium channels play an important role in endothelial function, but data from humans are lacking. This study included 15 healthy, sedentary, elderly males for a double blinded, randomized controlled trial. For 8 weeks, they were given 40 mg/day of either efonidipine (L- and T-type calcium channel blocker (CCB)) or nifedipine (L-type CCB). Vascular function was evaluated by graded femoral arterial infusions of acetylcholine (ACh; endothelium-dependent vasodilator) and sodium nitroprusside (endothelium-independent vasodilator) both with and without co-infusion of N-acetylcysteine (NAC; antioxidant). We measured leg blood flow and mean arterial pressure and calculated leg vascular conductance to evaluate the leg vascular responses. Despite no significant change in blood pressure in either group, we observed higher leg blood flow responses (Δ 0.43 ± 0.45 l/min, P = 0.006) and leg vascular conductance (Δ 5.38 ± 5.67 ml/min/mmHg, P = 0.005) to intra-arterial ACh after efonidipine, whereas there was no change in the nifedipine group, and no differences between groups. We found no upregulation of endothelial nitric oxide synthase in vastus lateralis muscle biopsies within or between groups. Smooth muscle cell responsiveness was unaltered by efonidipine or nifedipine. Intravenous co-infusion of NAC did not affect endothelium-dependent vasodilatation in either of the CCB groups. These results suggest that 8 weeks' inhibition of T- and L-type calcium channels augments endothelium-dependent vasodilatory function in healthy elderly males. Further studies are required to elucidate if T-type calcium channel inhibition can counteract endothelial dysfunction.
MeSH term(s)	Humans ; Male ; Calcium Channels, T-Type/metabolism ; Calcium Channels, T-Type/drug effects ; Aged ; Calcium Channel Blockers/pharmacology ; Nifedipine/pharmacology ; Pilot Projects ; Double-Blind Method ; Endothelium, Vascular/drug effects ; Endothelium, Vascular/metabolism ; Endothelium, Vascular/physiology ; Dihydropyridines/pharmacology ; Vasodilation/drug effects ; Vasodilation/physiology ; Vasodilator Agents/pharmacology ; Blood Pressure/drug effects ; Blood Pressure/physiology ; Regional Blood Flow/drug effects ; Regional Blood Flow/physiology ; Organophosphorus Compounds/pharmacology ; Acetylcholine/pharmacology ; Leg/blood supply ; Nitroprusside/pharmacology ; Middle Aged ; Nitrophenols
Chemical Substances	Calcium Channels, T-Type ; Calcium Channel Blockers ; Nifedipine (I9ZF7L6G2L) ; Dihydropyridines ; Vasodilator Agents ; efonidipine (40ZTP2T37Q) ; Organophosphorus Compounds ; Acetylcholine (N9YNS0M02X) ; Nitroprusside (169D1260KM) ; Nitrophenols
Language	English
Publishing date	2024-03-06
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	1016295-1
ISSN	1469-445X ; 0958-0670
ISSN (online)	1469-445X
ISSN	0958-0670
DOI	10.1113/EP091645
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Article: Fidelity and tolerability of two high-intensity interval training protocols in patients with COPD: a randomised cross-over pilot study.

Nymand, Stine Buus / Hartmann, Jacob / Rasmussen, Iben Elmerdahl / Iepsen, Ulrik Winning / Ried-Larsen, Mathias / Christensen, Regitse Højgaard / Berg, Ronan Martin Griffin

BMJ open sport & exercise medicine

2023 Volume 9, Issue 1, Page(s) e001486

Abstract: Objectives: High-intensity interval training (HIIT) during pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD) may alleviate the symptom burden, but the fidelity and tolerability of HIIT using long or short intervals ... ...

Abstract	Objectives: High-intensity interval training (HIIT) during pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD) may alleviate the symptom burden, but the fidelity and tolerability of HIIT using long or short intervals in patients with COPD are unknown. Methods: Twelve patients with moderate-to-severe COPD were included in a randomised cross-over pilot study. They completed two supervised HIIT protocols (4×4 and 10×1). To compare the two HIIT protocols, completed training amount, exercise intensity and perceived tolerability (assessed by a 10-point Likert scale) were integrated in a red-amber-green rating system. If a training session received a red ranking, it was considered unacceptable, if it received an amber ranking it was applicable with precautions, and if it received a green ranking it was considered feasible. Results: All patients completed the total training amount in both protocols. The 4×4 protocol resulted in three amber training sessions due to low perceived tolerability. The 10×1 protocol resulted in two red training sessions due to intensity reductions, and two amber training sessions because of low perceived tolerability. There was no statistical difference in perceived tolerability or time spent with an HR ≥85% of HR Conclusions: HIIT using longer intervals (4×4) at a relatively lower intensity resulted in higher fidelity expressed by fewer adjustments to the protocol, whereas there was no difference between protocols in perceived tolerance. The 4×4 protocol seems to have a higher fidelity compared with the 10×1 protocol in patients with moderate-to-severe COPD. Trial registration number: NCT05273684.
Language	English
Publishing date	2023-03-08
Publishing country	England
Document type	Journal Article
ZDB-ID	2817580-3
ISSN	2055-7647
ISSN	2055-7647
DOI	10.1136/bmjsem-2022-001486
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Article ; Online: Doppler Ultrasound-Based Leg Blood Flow Assessment During Single-Leg Knee-Extensor Exercise in an Uncontrolled Setting.

Hartmann, Jacob Peter / Krabek, Rikke / Nymand, Stine B / Hartmeyer, Helene / Gliemann, Lasse / Berg, Ronan M G / Iepsen, Ulrik Winning

Journal of visualized experiments : JoVE

2023 , Issue 202

Abstract: Doppler ultrasound has revolutionized the assessment of organ blood flow and is widely used in research and clinical settings. While Doppler ultrasound-based assessment of contracting leg muscle blood flow is common in human studies, the reliability of ... ...

Abstract	Doppler ultrasound has revolutionized the assessment of organ blood flow and is widely used in research and clinical settings. While Doppler ultrasound-based assessment of contracting leg muscle blood flow is common in human studies, the reliability of this method requires further investigation. Therefore, this study aimed to investigate the within-day test-retest, between-day test-retest, and inter-rater reliability of Doppler ultrasound for assessing leg blood flow during rest and graded single-leg knee-extensions (0 W, 6 W, 12 W, and 18 W), with the ultrasound probe being removed between measurements. The study included thirty healthy subjects (age: 33 ± 9.3, male/female: 14/16) who visited the laboratory on two different experimental days separated by 10 days. The study did not control for major confounders such as nutritional state, time of day, or hormonal status. Across different exercise intensities, the results demonstrated high within-day reliability with a coefficient of variation (CV) ranging from 4.0% to 4.3%, acceptable between-day reliability with a CV ranging from 10.1% to 20.2%, and inter-rater reliability with a CV ranging from 17.9% to 26.8%. Therefore, in a real-life clinical scenario where controlling various environmental factors is challenging, Doppler ultrasound can be used to determine leg blood flow during submaximal single-leg knee-extensor exercise with high within-day reliability and acceptable between-day reliability when performed by the same sonographer.
MeSH term(s)	Humans ; Female ; Male ; Young Adult ; Adult ; Leg/diagnostic imaging ; Leg/blood supply ; Reproducibility of Results ; Exercise/physiology ; Regional Blood Flow ; Muscle, Skeletal ; Ultrasonography, Doppler
Language	English
Publishing date	2023-12-15
Publishing country	United States
Document type	Journal Article ; Video-Audio Media
ZDB-ID	2259946-0
ISSN	1940-087X ; 1940-087X
ISSN (online)	1940-087X
ISSN	1940-087X
DOI	10.3791/65746
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Article ; Online: Dual Test Gas Pulmonary Diffusing Capacity Measurement During Exercise in Humans Using the Single-Breath Method.

Nymand, Stine B / Hartmann, Jacob Peter / Hartmeyer, Helene Louise / Rasmussen, Iben E / Andersen, Amalie Bach / Mohammad, Milan / Al-Atabi, Susan / Hanel, Birgitte / Iepsen, Ulrik Winning / Mortensen, Jann / Berg, Ronan M G

Journal of visualized experiments : JoVE

2024 , Issue 204

Abstract: The combined single-breath measurement of the diffusing capacity of carbon monoxide (DL,CO) and nitric oxide (DL,NO) is a useful technique to measure pulmonary alveolar-capillary reserve in both healthy and patient populations. The measurement provides ... ...

Abstract	The combined single-breath measurement of the diffusing capacity of carbon monoxide (DL,CO) and nitric oxide (DL,NO) is a useful technique to measure pulmonary alveolar-capillary reserve in both healthy and patient populations. The measurement provides an estimate of the participant's ability to recruit and distend pulmonary capillaries. The method has recently been reported to exhibit a high test-retest reliability in healthy volunteers during exercise of light to moderate intensity. Of note, this technique permits up to 12 repeated maneuvers and only requires a single breath with a relatively short breath-hold time of 5 s. Representative data are provided showing the gradual changes in DL,NO and DL,CO from rest to exercise at increasing intensities of up to 60% of maximal workload. The measurement of diffusing capacity and evaluation of alveolar-capillary reserve is a useful tool to evaluate the lung's ability to respond to exercise both in the healthy population as well as in patient populations such as those with chronic lung disease.
MeSH term(s)	Humans ; Pulmonary Diffusing Capacity ; Reproducibility of Results ; Exercise ; Lung ; Carbon Monoxide ; Nitric Oxide ; Exercise Test
Chemical Substances	Carbon Monoxide (7U1EE4V452) ; Nitric Oxide (31C4KY9ESH)
Language	English
Publishing date	2024-02-02
Publishing country	United States
Document type	Journal Article ; Video-Audio Media
ZDB-ID	2259946-0
ISSN	1940-087X ; 1940-087X
ISSN (online)	1940-087X
ISSN	1940-087X
DOI	10.3791/65871
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Article ; Online: Exercise adaptations in COPD: the pulmonary perspective.

Nymand, Stine B / Hartmann, Jacob P / Ryrsø, Camilla Koch / Rossen, Ninna Struck / Christensen, Regitse Højgaard / Iepsen, Ulrik Winning / Berg, Ronan M G

American journal of physiology. Lung cellular and molecular physiology

2022 Volume 323, Issue 6, Page(s) L659–L666

Abstract: In chronic obstructive pulmonary disease (COPD), the progressive loss of lung tissue is widely considered irreversible. Thus, various treatment and rehabilitation schemes, including exercise-based pulmonary rehabilitation (PR) are thought to slow down ... ...

Abstract	In chronic obstructive pulmonary disease (COPD), the progressive loss of lung tissue is widely considered irreversible. Thus, various treatment and rehabilitation schemes, including exercise-based pulmonary rehabilitation (PR) are thought to slow down but not reverse or halt the disease. Nonetheless, the adult lung conceals the intrinsic capacity for de novo lung tissue formation in the form of abundant progenitor/stem cell populations. In COPD, these maintain their differentiation potential but appear to be halted by a state of cellular senescence in the mesenchyme, which normally functions to support and coordinate their function. We propose that notably high-intensity interval training may improve pulmonary gas exchange during exercise in patients with COPD by interrupting mesenchymal senescence, thus reestablishing adaptive angiogenesis. By means of this, the downward spiral of dyspnea, poor quality of life, physical inactivity, and early death often observed in COPD may be interrupted. If this is the case, the perception of the regenerative capacity of the lungs will be fundamentally changed, which will warrant future clinical trials on various exercise schemes and other treatments targeting the formation of new lung tissue in COPD.
MeSH term(s)	Adult ; Humans ; Quality of Life ; Pulmonary Disease, Chronic Obstructive/therapy ; Lung ; Dyspnea/rehabilitation ; Exercise ; Exercise Tolerance ; Exercise Therapy
Language	English
Publishing date	2022-09-27
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1013184-x
ISSN	1522-1504 ; 1040-0605
ISSN (online)	1522-1504
ISSN	1040-0605
DOI	10.1152/ajplung.00549.2020
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Article ; Online: Management of pneumothorax differs across Denmark.

Iepsen, Ulrik Winning / Ringbaek, Thomas

Danish medical journal

2014 Volume 61, Issue 3, Page(s) A4803

Abstract: Introduction: Pneumothorax is a common problem in Denmark. Guidelines recommend insertion of small-bore (≤ 14 Fr) chest tubes or simple needle aspiration in spontaneous pneumothorax. Our objective was to investigate the management of pneumothorax in ... ...

Abstract	Introduction: Pneumothorax is a common problem in Denmark. Guidelines recommend insertion of small-bore (≤ 14 Fr) chest tubes or simple needle aspiration in spontaneous pneumothorax. Our objective was to investigate the management of pneumothorax in Danish hospitals. Material and methods: We undertook a questionnaire survey at all Danish acute hospitals enquiring about current practice in the management of pneumothorax. A questionnaire was sent to 35 hospitals in May 2013. After follow-up in September 2013, a total of 32 completed questionnaires were assessed. Results: We found that three hospitals (10.7%) used simple needle aspiration in primary spontaneous pneumothorax. The majority of the hospitals treated all types of pneumothorax by inserting chest tubes with a traditional small thoracotomy (75%), and most hospitals used large-bore (> 14 Fr) chest tubes (85.7%). There were no regional differences in the management of pneumothorax among the five regions in Denmark (p > 0.05), but we found a trend towards use of less invasive techniques in hospitals with departments of either Respiratory Medicine or Thoracic Surgery. Conclusion: Management of pneumothorax in Denmark is mainly based on insertion of a large-bore (> 14 Fr) chest tube by a traditional small thoracotomy. Only a few hospitals in Denmark use minimally invasive techniques in the management of spontaneous pneumothorax. We speculate that implementation of these techniques may reduce hospital admission time for patients with spontaneous pneumothorax in Denmark. Funding: not relevant. Trial registration: not relevant.
MeSH term(s)	Denmark ; Emergency Service, Hospital ; Humans ; Length of Stay ; Pneumothorax/therapy ; Practice Patterns, Physicians'/statistics & numerical data ; Suction ; Thoracotomy/utilization
Language	English
Publishing date	2014-03
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	2648771-8
ISSN	2245-1919 ; 2245-1919
ISSN (online)	2245-1919
ISSN	2245-1919
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Article ; Online: Skeletal muscle protein turnover responses to parenteral nutrition in patients with alcoholic liver cirrhosis and sarcopenia.

Iepsen, Ulrik Winning / Rinnov, Anders Rasmussen / Munch, Gregers Winding / Rugbjerg, Mette / Winding, Kamilla Munch / Lauridsen, Carsten / Berg, Ronan M G / Pedersen, Bente Klarlund / Gluud, Lise Lotte / van Hall, Gerrit

American journal of physiology. Gastrointestinal and liver physiology

2023 Volume 325, Issue 2, Page(s) G174–G183

Abstract: Alcoholic liver cirrhosis (ALC) is accompanied by sarcopenia. The aim of this study was to investigate the acute effects of balanced parenteral nutrition (PN) on skeletal muscle protein turnover in ALC. Eight male patients with ALC and seven age- and sex- ...

Abstract	Alcoholic liver cirrhosis (ALC) is accompanied by sarcopenia. The aim of this study was to investigate the acute effects of balanced parenteral nutrition (PN) on skeletal muscle protein turnover in ALC. Eight male patients with ALC and seven age- and sex-matched healthy controls were studied for 3 h of fasting followed by 3 h of intravenous PN (SmofKabiven 1,206 mL: amino acid = 38 g, carbohydrates = 85 g, and fat = 34 g) 4 mL/kg/h. We measured leg blood flow and sampled paired femoral arteriovenous concentrations and quadriceps muscle biopsies while providing a primed continuous infusion of [ring-
MeSH term(s)	Humans ; Male ; Amino Acids/metabolism ; Liver Cirrhosis/metabolism ; Liver Cirrhosis, Alcoholic/therapy ; Liver Cirrhosis, Alcoholic/metabolism ; Muscle Proteins/metabolism ; Muscle Proteins/pharmacology ; Muscle, Skeletal/metabolism ; Parenteral Nutrition ; Phenylalanine ; Sarcopenia/complications ; Case-Control Studies
Chemical Substances	Amino Acids ; Muscle Proteins ; Phenylalanine (47E5O17Y3R)
Language	English
Publishing date	2023-06-20
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	603840-2
ISSN	1522-1547 ; 0193-1857
ISSN (online)	1522-1547
ISSN	0193-1857
DOI	10.1152/ajpgi.00242.2022
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Article ; Online: Pulmonary diffusing capacity to nitric oxide and carbon monoxide during exercise and in the supine position: a test-retest reliability study.

Madsen, Anna Christrup / Thomsen, Rie Skovly / Nymand, Stine B / Hartmann, Jacob Peter / Rasmussen, Iben E / Mohammad, Milan / Skovgaard, Lene Theil / Hanel, Birgitte / Jønck, Simon / Iepsen, Ulrik Winning / Chistensen, Regitse H / Mortensen, Jann / Berg, Ronan M G

Experimental physiology

2023 Volume 108, Issue 2, Page(s) 307–317

Abstract: New findings: What is the central question in this study? How reliable is the combined measurement of the pulmonary diffusing capacity to carbon monoxide and nitric oxide (D: Abstract: ... ...

Abstract	New findings: What is the central question in this study? How reliable is the combined measurement of the pulmonary diffusing capacity to carbon monoxide and nitric oxide (D Abstract: D
MeSH term(s)	Male ; Female ; Humans ; Adult ; Pulmonary Diffusing Capacity/physiology ; Carbon Monoxide ; Nitric Oxide ; Reproducibility of Results ; Supine Position
Chemical Substances	Carbon Monoxide (7U1EE4V452) ; Nitric Oxide (31C4KY9ESH)
Language	English
Publishing date	2023-01-09
Publishing country	England
Document type	Randomized Controlled Trial ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1016295-1
ISSN	1469-445X ; 0958-0670
ISSN (online)	1469-445X
ISSN	0958-0670
DOI	10.1113/EP090883
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Article ; Online: Small-bore chest tubes seem to perform better than larger tubes in treatment of spontaneous pneumothorax.

Iepsen, Ulrik Winning / Ringbæk, Thomas

Danish medical journal

2013 Volume 60, Issue 6, Page(s) A4644

Abstract: Introduction: The aim of this study was to compare the efficacy and complications of surgical (large-bore) chest tube drainage with smaller and less invasive chest tubes in the treatment of non-traumatic pneumothorax (PT). : Material and methods: ... ...

Abstract	Introduction: The aim of this study was to compare the efficacy and complications of surgical (large-bore) chest tube drainage with smaller and less invasive chest tubes in the treatment of non-traumatic pneumothorax (PT). Material and methods: This was a retrospective study of 104 cases (94 patients) of non-traumatic PT treated with chest tubes - either by pulmonary physicians (daytime and weekdays) using small-bore chest tubes, or by orthopaedic surgeons (remaining time slots) using large-bore chest tubes. Results: A total of 62 had primary spontaneous PT, 30 had secondary spontaneous PT and 12 had iatrogenic PT. A total of 62 patients were treated with large-bore (20-28 Fr) chest tubes placed with traditional thoracotomy, 42 patients were treated by a pulmonary physician, and in 30 of these cases a True-Close thoracic vent (11-13 Fr) was inserted. Patients treated with surgical chest tubes were comparable with patients treated with smaller chest tubes in terms of demographic data and type and size of PT. Compared with patients treated with smaller chest tubes, patients with surgical large-bore tubes had more complications (27.4% versus 9.5%; p = 0.026), a lower success rate (56.5% versus 85.7%; p = 0.002), and longer duration of chest tube (8.3 versus 4.9 days; p = 0.001) and of hospitalisation (11.8 versus 6.9 days; p = 0.004). Conclusion: We found small chest tubes to be superior to large-bore chest tubes with regard to short-term outcomes in the treatment of non-traumatic PT. Funding: not relevant. Trial registration: The project was approved by the Danish Data Protection Agency, file no. 2012-41-0554.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Chest Tubes/adverse effects ; Drainage/instrumentation ; Female ; Humans ; Length of Stay ; Male ; Middle Aged ; Pneumothorax/surgery ; Retrospective Studies ; Thoracostomy/instrumentation ; Treatment Outcome ; Young Adult
Language	English
Publishing date	2013-06
Publishing country	Denmark
Document type	Comparative Study ; Journal Article
ZDB-ID	2648771-8
ISSN	2245-1919 ; 2245-1919
ISSN (online)	2245-1919
ISSN	2245-1919
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