Browsing by Author "Perry B"

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    Critical power is a key threshold determining the magnitude of post-exercise hypotension in non-hypertensive young males.
    (Wiley & Sons Ltd on behalf of The Physiological Society, 2023-09-15) Lei T-H; Wang I-L; Chen Y-M; Liu X-H; Fujii N; Koga S; Perry B; Mundel T; Wang F; Cao Y; Dobashi K; Kondo N; Li H-Y; Goulding RP; Poole D
    The effect of different exercise intensities on the magnitude of post-exercise hypotension has not been rigorously clarified with respect to the metabolic thresholds that partition discrete exercise intensity domains (i.e., critical power and the gas exchange threshold (GET)). We hypothesized that the magnitude of post-exercise hypotension would be greater following isocaloric exercise performed above versus below critical power. Twelve non-hypertensive men completed a ramp incremental exercise test to determine maximal oxygen uptake and the GET, followed by five exhaustive constant load trials to determine critical power and W' (work available above critical power). Subsequently, criterion trials were performed at four discrete intensities matched for total work performed (i.e., isocaloric) to determine the impact of exercise intensity on post-exercise hypotension: 10% above critical power (10% > CP), 10% below critical power (10% < CP), 10% above GET (10% > GET) and 10% below GET (10% < GET). The post-exercise decrease (i.e., the minimum post-exercise values) in mean arterial (10% > CP: -12.7 ± 8.3 vs. 10% < CP: v3.5 ± 2.9 mmHg), diastolic (10% > CP: -9.6 ± 9.8 vs. 10% < CP: -1.4 ± 5.0 mmHg) and systolic (10% > CP: -23.8 ± 7.0 vs. 10% < CP: -9.9 ± 4.3 mmHg) blood pressures were greater following exercise performed 10% > CP compared to all other trials (all P < 0.01). No effects of exercise intensity on the magnitude of post-exercise hypotension were observed during exercise performed below critical power (all P > 0.05). Critical power represents a threshold above which the magnitude of post-exercise hypotension is greatly augmented. NEW FINDINGS: What is the central questions of this study? What is the influence of exercise intensity on the magnitude of post-exercise hypotension with respect to metabolic thresholds? What is the main finding and its importance? The magnitude of post-exercise hypotension is greatly increased following exercise performed above critical power. However, below critical power, there was no clear effect of exercise intensity on the magnitude of post-exercise hypotension.
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    Protocol for the INFORM ASTHMA Trial: budesonide–formoterol reliever in adults with asthma on maintenance inhaled corticosteroid
    (European Respiratory Society, 2025-07-07) Noble J; Bean O; Bruce P; Black M; Sayers R; Cullen R; Black B; Holliday M; Kirton L; Perry B; Eathorne A; Pavord I; Weatherall M; Beasley R
    Background International asthma guidelines recommend inhaled corticosteroid (ICS)/formoterol in preference to short-acting β2-agonist (SABA) reliever-based regimens as reliever therapy in adults and adolescents of all asthma severities. A major limitation to this recommendation is the absence of randomised controlled trial (RCT) efficacy and safety data for this approach in patients who continue to use maintenance ICS. The anti-inflammatory effect of ICS/formoterol reliever therapy on airway inflammation is also not well characterised. Objective The objective of the present study is to determine the anti-inflammatory effect, efficacy and safety of budesonide–formoterol reliever therapy versus terbutaline reliever therapy in adults with asthma on maintenance ICS therapy. Fractional exhaled nitric oxide (FENO) will specifically be examined to determine the time-course and magnitude of the anti-inflammatory effect. Methods A 26-week, open-label, parallel-group, 2-arm, phase IV, two-sided superiority RCT will recruit 180 adults aged 16–75 years with a clinical diagnosis of asthma using reliever only therapy, or SABA reliever therapy with maintenance ICS at baseline, and with baseline FENO at screening ≥25 ppb. Enrolled participants will be allocated to maintenance budesonide with the dose based on their baseline treatment step and randomised 1:1 to either budesonide–formoterol or terbutaline reliever therapy. All participants will perform at-home FENO measurements at regular intervals for the first 12 weeks of the study. The primary outcome is FENO at 26 weeks. Key secondary outcomes include FENO time-course, asthma exacerbations, asthma control and spirometry. Conclusion This will be the first RCT comparing ICS/formoterol versus SABA reliever therapy in patients who use maintenance ICS therapy.