Conflicting data have been reported on "sports anaemia" and anaemia during physical training. Most of these results are of studies at rest before or after training. The aim of this investigation was to further study the profiles of serum iron (Se Fe) and transferrin (Se Tr), in 14 physically trained men (28 +/- 6 years) during an exhaustive interval training session. The 45 min Square-Wave Endurance Exercise Test (SWEET) was performed on a cycle ergometer. To the SWEET base, established as a % of individual VO2max, a peak of 1 min at VO2max was added every 5 minutes. Arterial blood samples were taken at rest, during the SWEET at the 14th, 15th, 29th, 30th, 44th and 45th minutes, just before and after the peaks, and at the 15th min of recovery. Lactate, acidity [H+], PaCO2, PaO2, Haematocrit (Hct), Haemoglobin (Hb), Se Fe and Se Tr were measured. After the SWEET, weight loss was 0.89 +/- 0.15 kg. Lactate and serum iron rose progressively at the base levels and at the peaks, while PaCO2 and bicarbonate fell progressively. Hct, [Hb], serum transferrin and [H+] increased significantly at the 14th min of SWEET and thereafter no change was observed. At the 45th min with respect to the value at rest, Se Fe increased as much as +32%, Se Tr +13% and [Hb] +8%. Haemoconcentration could explain the changes in Se Tr but not the total significant increase in Se, Fe, which moreover is not explained by acidosis [H+].(ABSTRACT TRUNCATED AT 250 WORDS)

(1978). Thorax, 33,[345][346][347][348][349][350][351]. Breath sounds in the clinical assessment of airflow obstruction. In a group of 34 inpatients showing varying degrees of airflow obstruction we studied the relationship between breath sound intensity (BSI) and abnormalities of lung function. The BSI was evaluated by chest auscultation to provide a score, in a manner similar to that described by Pardee et al. (1976), and was found to correlate closely with indices of airflow obstruction or their logarithms such as specific conductance (r=0O759), maximal expiratory flow at 50% of vital capacity (r=0-790), forced expiratory volume in one second (r=0-768), and forced expiratory volume to vital capacity ratio (r=0-860). Correlations with lung volumes, although statistically significant, were weaker. Multiple correlation studies showed that BSI score correlated independently with indices of both airflow obstruction and lung distension.In our experience, BSI score can be useful not only in the detection but also the quantification of airflow obstruction, although its predictive power is impaired in subjects with associated restrictive disorders. It can also fail to detect mild, pure airflow obstruction.It is a current concept that the severity of functional impairment in patients with airflow obstruction is poorly related to physical signs and symptoms. Indeed, although patients with moderately severe airflow obstruction usually exhibit several symptoms and signs, assessment of obstruction on a clinical basis can be misleading and subjects with severe functional impairment may be entirely overlooked, whereas normal subjects may be misdiagnosed (Schneider and Anderson, 1965

Background -The use oflung sound mon-

15 patients with chronic airway obstruction were submitted to a program of pulmonary rehabilitation. After having been studied first with clinical, radiological and functional tests (spirometry, spontaneous breathing and arterial blood gases), they were treated in the respiratory ambulance care unit for about 4 weeks. Subsequently they were hospitalized. On entering the hospital, the same tests were performed and were completed by (a) plethysmographic measurements (TLC, FRC, Raw) and flow volume curves, (b) arterial blood gases (pH, PaCO₂, PaO₂) and hematocrit, at rest and at 40-watt exercise, and (c) determination of VO_2max. The treatment consisted of (1) bronchodilators and, if necessary, antibiotics, (2) directed breathing (DB) and (3) a 30-min exercise session daily with an oxygen cart (FIO₂ 0.35) and DB. The length of the treatment varied between 3 and 6 weeks, and afterwards the whole set of clinical and functional tests was started again. There was no noticeable difference between the first consultation and just before treatment at the hospital. The lack of beneficial effects, while the patients were ambulatory, shows that the drugs used are not helpful in producing long-lasting changes. After pulmonary rehabilitation, subjective and objective improvement could be ascertained for most patients. There was an improvement in the maximal mobility of the diaphragm (3 ± 1.2 and 4 ± 1.4 cm to 5 ± 1.6 and 7 ± 2.1 cm on the right and left side, respectively; p < 0.001 in both cases) in VC (p < 0.001), FEV₁/VC % (p < 0.01), maximal flow at 50% of VC (p < 0.05), PaO2 at rest (p < 0.01) and at 40-watt exercise (p < 0.001), and tidal volume at rest and at maximal exercise level (p < 0.01), while the respiratory rate was lower (p < 0.02). VO_2max increased significantly (p < 0.01). These results, much more conclusive than the results of each of these three treatments taken one by one, confirm the objective efficacy of the association of the therapeutic means available.

A group of 6 males with severe α₁-antitrypsin deficiency, underwent clinical and pulmonary function evaluation. Findings were compared to those in a group of males with different degrees of airflow obstruction, comparable ages and tobacco consumption, but with normal serum levels of α₁-antitrypsin. The deficient group was characterized by: (1) a relatively early appearance of symptoms; (2) disturbed lung scans, mostly in the basal zones; (3) radiological evidence, in most cases, of pulmonary emphysema with, in particular, bullae in the lower lung zones; (4) hypoxemia without hypercapnia and a decreased TCO/ VA, and (5) a more or less severe reduction of maximal expiratory flows largely, but not exclusively due to a decrease in lung elastic recoil. Clinical and functional parameters did not permit a clear distinction between the deficient and non-deficient groups.