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In 10 healthy subjects, skin blood flow rate was measured in the thumb pulp by the heat-washout method, and in the skin fold between the thumb and the forefinger by the [sup133]Xe-washout method. The former but not the latter skin area contains arteriovenous anastomoses (AVAs). In response to 10 min moderate bicycle exercise, an instantaneous decrease in flow was seen in the thumb pulp followed after about 4.6 min by an increase to resting levels. Blood flow in the skin fold remained constant. The results indicate that the initial reduction in blood flow rate and later increase observed in the finger at the onset of moderate exercise take place in the AVAs and not in the capillaries. [ABSTRACT FROM AUTHOR]

Background: Due to increasing older populations worldwide, injuries, disabilities and deaths caused by falls among the elderly represent a growing human and societal problem. We aimed to improve health among men of at least 70 years of age with low-normal to low testosterone and mobility problems by using testosterone undecanoate (TU) injections, progressive strength training, and oral supplements of vitamin D, calcium and protein., Methods: This was a single-centre, randomized, placebo-controlled, double-blind trial with 148 older men with a median age of 77 (73-81) years, testosterone levels at median 8 (5-9) nmol/L (full range from 1.1 to 12.9 nmol/L) and mobility problems, recruited at University Hospital of Copenhagen, Herlev Hospital, Denmark. Participants were randomized into four arms for 20 weeks: (1) TU therapy (n = 37); (2) progressive resistance training with supplements of calcium, vitamin D and protein (n = 36); (3) both interventions combined (n = 36); or (4) no intervention (n = 39). The main outcome measure was the 30-s chair stand test, due to test performance correlating with the risk of serious fall injuries and lower extremity muscle strength. Outcome measurements were performed at baseline and after 20 weeks., Results: After the intervention, the combination group receiving progressive resistance training, TU and supplements achieved a median score of 13 (11-15) compared to the control group at 10 (0-14) in the 30-s chair stand test (P = 0.003). This median improvement of 3.0 was clinically important. Compared to the control group, participants in the combination group also increased quality of life (P < 0.05) and reduced both tiredness (P < 0.05) and leg fat (P < 0.05) and had higher variability in the RR interval (P < 0.01). The group receiving TU reduced gynoid and leg fat compared to the control group (both P < 0.05). Blood tests improved for several variables, especially in the combination group. There was no statistically significant increase in adverse effects from either the supplements or training., Conclusions: In men ≥70 years old with low-normal to low testosterone and mobility problems, supplements of testosterone, calcium, vitamin D and protein combined with progressive resistance training improved 30-s chair stand test performance, muscle strength and quality of life. Both tiredness and leg fat were reduced, and RR interval variability was increased. Significant adverse effects were not observed., (© 2024 The Author(s). Journal of Cachexia, Sarcopenia and Muscle published by Wiley Periodicals LLC.)

Introduction: Cellulitis is a common infection, especially among the elderly, and compression therapy is often recommended to reduce acute oedema and pain. A previous study showed that compression therapy led to a lower incidence of recurrent cellulitis in lower extremities in patients with chronic oedema. The aim of this study was to describe clinical characteristics of patients with cellulitis., Methods: This was a retrospective descriptive study reviewing medical records and medicine registrations in patients ≥ 18 years with cellulitis., Results: A total of 104 patients were hospitalised with cellulitis; 13 were excluded. The median age was 75 years (range: 33-103 years), 64% > 70 years. The median admission time was five days (range: 1-24 days). Median antibiotic treatment duration was 11 days (range: 4-56 days). A total of 45% were current or former smokers, 40% were overweight, 48% had preexisting chronic oedema of the affected area, 90% had become infected in the lower extremities and 19% were readmitted within six months. A total of 51% had a new antibiotic treatment prescribed after being discharged, and 66% received compression therapy., Conclusions: Cellulitis frequently affects older patients, especially smokers, people with overweight and chronic lymphoedema. In all, 66% were treated with compression therapy that did not have a clear effect on their readmission rate, probably because the patients receiving compression therapy had a more severe infection complicated by severe oedema and a higher risk of reinfection. An increased focus on the use of compression therapy in conjunction with health preventive interventions may have a positive impact on the relapse rate., Funding: None., Trial Registration: Not relevant., (Published under Open Access CC-BY-NC-BD 4.0. https://creativecommons.org/licenses/by-nc-nd/4.0/.)

Introduction: Osteoporosis and osteoporotic fractures typically affect postmenopausal women, and osteoporotic fractures significantly increase disability, morbidity and mortality. Several anti-osteoporotic agents are available and have been shown to effectively reduce the incidence of low-energy osteoporotic fractures. However, the post-osteoporotic fracture treatment rate remains low. The purpose of the present study was to follow up on patients with a recent hip fracture with primary focus on anti-osteoporotic treatment and dual-energy X-ray absorptiometry (DXA)., Methods: We included patients ≥ 65 years of age admitted to a department of orthopaedic surgery in Denmark from 1 June 2019 to 30 May 2020., Results: In this period, 570 patients ≥ 65 years were treated for a hip fracture. A total of 16.7% of the patients received anti-osteoporotic treatment at follow-up and 6.5% initiated anti-osteoporotic treatment or had a relevant change in anti-osteoporotic treatment. Only 9.8% had a DXA after their fracture; and among this group, 48% received anti-osteoporotic treatment., Conclusion: The majority of patients with a recent low-energy hip fracture did not receive a DXA, did not have a relevant follow-up or received any anti-osteoporotic treatment. The problem is global and needs to be addressed. Starting treatment with anti-osteoporotic medicine before discharge from the orthopaedic department and referring the patient to a DXA at the same time may be part of the solution., Funding: none., Trail Registration: not relevant., (Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.)

Purpose: This study examined the associations among common assessments for measuring strength and power in the lower body of high-performing athletes, including both cross-sectional and longitudinal data., Methods: A total of 100 participants, including both male (n = 83) and female (n = 17) athletes (21 [4] y, 182 [9] cm, 78 [12] kg), were recruited for the study using a multicenter approach. The participants underwent physical testing 4 times. The first 2 sessions (1 and 2) were separated by ∼1 week, followed by a period of 2 to 6 months, whereas the last 2 sessions (3 and 4) were also separated by ∼1 week. The test protocol consisted of squat jumps, countermovement jumps, jump and reach, 30-m sprint, 1-repetition-maximum squat, sprint cycling, and a leg-press test., Results: There were generally acceptable correlations among all performance measures. Variables from the countermovement jumps and leg-press power correlated strongly with all performance assessments (r = .52-.79), while variables from sprint running and squat-jump power displayed more incoherent correlations (r = .21-.82). For changes over time, the correlations were mostly strong, albeit systematically weaker than for cross-sectional measures., Conclusions: The associations observed among the performance assessments seem to be consistent for both cross-sectional data and longitudinal change scores. The weaker correlations for change scores are most likely mainly caused by lower between-subjects variations in the change scores than for the cross-sectional data. The present study provides novel information, helping researchers and practitioners to better interpret the relationships across common performance assessment methods.

Purpose: This study examined the test-retest reliability of common assessments for measuring strength and power of the lower body in high-performing athletes., Methods: A total of 100 participants, including both male (n = 83) and female (n = 17) athletes (21 [4] y, 182 [9] cm, and 78 [12] kg), were recruited for this study, using a multicenter approach. The participants underwent physical testing 4 times. The first 2 sessions (1 and 2) were separated by ∼1 week, followed by a period of 2 to 6 months, whereas the last 2 sessions (3 and 4) were again separated by ∼1 week. The test protocol consisted of squat jumps, countermovement jumps, jump and reach, 30-m sprint, 1-repetition-maximum squat, sprint cycling, and a leg-press test., Results: The typical error (%) ranged from 1.3% to 8.5% for all assessments. The change in means ranged from -1.5% to 2.5% for all assessments, whereas the interclass correlation coefficient ranged from .85 to .97. The smallest worthwhile change (0.2 of baseline SD) ranged from 1.2% to 5.0%. The ratio between the typical error (%) and the smallest worthwhile change (%) ranged from 0.5 to 1.2. When observing the reliability across testing centers, considerable differences in reliability were observed (typical error [%] ratio: 0.44-1.44)., Conclusions: Most of the included assessments can be used with confidence by researchers and coaches to measure strength and power in athletes. Our results highlight the importance of controlling testing reliability at each testing center and not relying on data from others, despite having applied the same protocol.

This is a case report of the first two cases of Candida auris in Denmark. Patient 1 was known to be colonized with C. auris when transferred from a foreign hospital to a Danish hospital. The patient was isolated during the entire hospitalization and the room was thoroughly cleaned after discharge. Patient 2 who had no travel history spent five hours in the room of Patient 1 after disinfection. One month later, C. auris was found in the blood of Patient 2. Transmission from Patient 1 to Patient 2 must be suspected.

Introduction: Utility of dipstick analysis must be investigated in patients admitted to the emergency department. The aim of this study was to evaluate if urine dipstick analysis can be used to detect significant bacteriuria. The cross-sectional study was performed in the Emergency Department of Copenhagen University Hospital - Herlev Hospital, Denmark., Methods: We recorded urine dipstick analysis of 500 adult patients admitted to the Emergency Department. Dipstick results were compared with urinary culture., Results: Sensitivity for leukocyte esterase (LE) was 80.9%, but specificity was 58%. The sensitivity of nitrite was 46.5%, and specificity was 90%. The positive predictive value (PPV) and negative predictive value (NPV) of LE for women were 54.5% and 75.9%; for men, 50.0% and 91.6%. PPV and NPV for nitrite in women were 85.9% and 66.8%; for men, 62.9% and 88.7%. Positive LE and positive nitrite had a PPV of 90.2% for women and 70.4% for men. Negative LE and negative nitrite had an NPV of 80.9% for women and 93.3% for men., Conclusions: No single parameter or combination of parameters on the urine dipstick analysis can be used reliably to predict positive urine culture in women. The most accurate predictor of negative urine culture in men is the combination of negative nitrites and negative LE. To minimize unnecessary use of antibiotics, treatment can be delayed in female patients with positive urine dipstick until urine culture results are available., Funding: none., Trial Registration: not relevant., (Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.)

Background: COVID-19, caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has great health implications in older patients, including high mortality. In general, older patients often have atypical symptom presentations during acute illness due to a high level of comorbidity. The purpose of this study was to investigate the presentation of symptoms at hospital admissions in older patients with COVID-19 and evaluate its impact on disease outcome., Methods: This retrospective study included patients ≥80 years of age with a positive test for SARS-CoV-2, who were admitted to one of three medical departments in Denmark from March 1st to June 1st, 2020., Results: A total of 102 patients (47% male) with a mean age of 85 years were included. The most common symptoms at admission were fever (74%), cough (62%), and shortness of breath (54%). Furthermore, atypical symptoms like confusion (29%), difficulty walking (13%), and falls (8%) were also present. In-hospital and 30-day mortality were 31% (n = 32) and 41% (n = 42), respectively. Mortality was highest in patients with confusion (50% vs 38%) or falls (63% vs 39%), and nursing home residency prior to hospital admission was associated with higher mortality (OR 2.7, 95% CI 1.1-6.7)., Conclusions: Older patients with SARS-Cov-2 displayed classical symptoms of COVID-19 but also geriatric frailty symptoms such as confusion and walking impairments. Additionally, both in-hospital and 30-day mortality was very high. Our study highlights the need for preventive efforts to keep older people from getting COVID-19 and increased awareness of frailty among those with COVID-19., (Copyright © 2020. Published by Elsevier B.V.)

The aim of the study was to examine the test-retest reliability and agreement across methods for assessing individual force-velocity (FV) profiles of the lower limbs in athletes. Using a multicenter approach, 27 male athletes completed all measurements for the main analysis, with up to 82 male and female athletes on some measurements. The athletes were tested twice before and twice after a 2- to 6-month period of regular training and sport participation. The double testing sessions were separated by ~1 week. Individual FV-profiles were acquired from incremental loading protocols in squat jump (SJ), countermovement jump (CMJ) and leg press. A force plate, linear encoder and a flight time calculation method were used for measuring force and velocity during SJ and CMJ. A linear regression was fitted to the average force and velocity values for each individual test to extrapolate the FV-variables: theoretical maximal force (F0), velocity (V0), power (Pmax), and the slope of the FV-profile (SFV). Despite strong linearity (R2>0.95) for individual FV-profiles, the SFV was unreliable for all measurement methods assessed during vertical jumping (coefficient of variation (CV): 14-30%, interclass correlation coefficient (ICC): 0.36-0.79). Only the leg press exercise, of the four FV-variables, showed acceptable reliability (CV:3.7-8.3%, ICC:0.82-0.98). The agreement across methods for F0 and Pmax ranged from (Pearson r): 0.56-0.95, standard error of estimate (SEE%): 5.8-18.8, and for V0 and SFV r: -0.39-0.78, SEE%: 12.2-37.2. With a typical error of 1.5 cm (5-10% CV) in jump height, SFV and V0 cannot be accurately obtained, regardless of the measurement method, using a loading range corresponding to 40-70% of F0. Efforts should be made to either reduce the variation in jumping performance or to assess loads closer to the FV-intercepts. Coaches and researchers should be aware of the poor reliability of the FV-variables obtained from vertical jumping, and of the differences across measurement methods., Competing Interests: The authors have declared that no competing interests exist.

The present randomized cross-over controlled study aimed to compare the rate of recovery from a strength-oriented exercise session vs. a power-oriented session with equal work. Sixteen strength-trained individuals conducted one strength-oriented session (five repetitions maximum (RM)) and one power-oriented session (50% of 5RM) in randomized order. Squat jump (SJ), countermovement jump (CMJ), 20-m sprint, and squat and bench press peak power and estimated 1RMs were combined with measures of rate of perceived exertion (RPE) and perceived recovery status (PRS), before, immediately after and 24 and 48 h after exercise. Both sessions induced trivial to moderate performance decrements in all variables. Small reductions in CMJ height were observed immediately after both the strength-oriented session (7 ± 6%) and power-oriented session (5 ± 5%). Between 24 and 48 h after both sessions CMJ and SJ heights and 20 m sprint were back to baseline. However, in contrast to the power-oriented session, recovery was not complete 48 h after the strength-oriented session, as indicated by greater impairments in CMJ eccentric and concentric peak forces, SJ rate of force development (RFD) and squat peak power. In agreement with the objective performance measurements, RPE and PRS ratings demonstrated that the strength-oriented session was experienced more strenuous than the power-oriented session. However, these subjective measurements agreed poorly with performance measurements at the individual level. In conclusion, we observed a larger degree of neuromuscular impairment and longer recovery times after a strength-oriented session than after a power-oriented session with equal total work, measured by both objective and subjective assessments. Nonetheless, most differences were small or trivial after either session. It appears necessary to combine several tests and within-test analyses (e.g., CMJ height, power and force) to reveal such differences. Objective and subjective assessments of fatigue and recovery cannot be used interchangeably; rather they should be combined to give a meaningful status for an individual in the days after a resistance exercise session., Competing Interests: Author Daniela Schäfer Olstad was employed by the company Polar Electro Oy. Of note, the present study does not contain any data collected by Polar Electro Oy equipment/devices. The remaining authors declare that they have no competing interests., (©2020 Helland et al.)

Cellulitis ranks among the most frequent infections, and antibiotic treatment is the accepted mainstay of therapy. There is disagreement on the guidelines for the use of compression bandaging as supplementary treatment, and the evidence within the field is scarce. To determine whether compression bandaging impairs microcirculation in patients with cellulitis of the lower leg, thereby having a negative impact on the supply of oxygen, nutritional components, and antibiotics. Adult patients were prospectively enrolled for compression bandaging in addition to antibiotic treatment. The peripheral blood flow rate was measured before and after application of the compression bandage and on the following day. For this, we applied the heat-washout method, which has previously been shown to provide an accurate estimate of peripheral microcirculation. Comparing the blood flow rate before and after application of the compression bandage showed no significant change and therefore no alteration in microcirculation (p = 0.61). Compression bandaging of the lower leg does not impair microcirculation in patients with cellulitis. This strongly indicates that compression bandaging can play a positive role as supportive treatment in addition to standard antibiotic therapy.

Background: Fall accidents are a major cause of mortality among the elderly and the leading cause of traumatic brain injury. After a fall, many elderly people never completely recover and need help in coping with everyday life. Due to the increasing older population in the world, injuries, disabilities, and deaths caused by falls are a growing worldwide problem. Muscle weakness leads to greatly increased risk of falling, decreased quality of life, and decline in functional capacity. Muscle mass and muscle power decrease about 40% from age 20 to 80 years, and the level of testosterone decreases with age and leads to impaired muscle mass. In addition, 20% of men older than 60 years-and 50% older than 80 years-have low levels of testosterone. Treatments after a fall are significant financial burdens on health and social care, and it is important to find treatments that can enhance function in the elderly people., Objective: The purpose of this study is to investigate whether testosterone and progressive resistance training alone or combined can improve muscle strength and reduce the risk of falls in older men. Additionally, we will examine whether such treatments can improve quality of life, functional capacity, including sexual function, and counteract depression., Methods: This is a randomized placebo-controlled, double-blind trial in which frail older men with testosterone deficiency are treated with testosterone supplemental therapy and therapist-assisted progressive resistance training for 20 weeks, with the possibility to continue treatment for 1 year. Four study arms of 48 participants each are provided based on factorial assignment to testosterone supplemental therapy and progressive resistance training. The 4 groups are as follows: controls given placebo injections without physical exercise for 20 weeks, testosterone-alone group given testosterone injections without physical exercise for 20 weeks, training-alone group given placebo injections for 20 weeks combined with 16 weeks of progressive strength training, and combination group given testosterone injections for 20 weeks combined with 16 weeks of progressive strength training. Performance in the 30-second chair stand test to measure improvement of general strength, balance, and power in lower extremities is the primary endpoint. Secondary endpoints comprising tests of cognition, muscle strength, and quality of life are applied before and after the training., Results: Funding was provided in October 2016. Results are expected to be available in 2020. Sample size was calculated to 152 participants divided into 4 equal-sized groups. Due to age, difficulty in transport, and the time-consuming intervention, up to 25% dropouts are expected; thus, we aim to include at least 192 participants., Conclusions: This investigation will evaluate the efficacy of testosterone supplemental therapy alone or combined with progressive resistance training. Additionally, improvements in quality of life and cognition are explored., Trial Registration: Clinicaltrials.gov NCT02873559; https://clinicaltrials.gov/ct2/show/NCT02873559 (Archived by WebCite at http://www.webcitation.org/6x0BhU2p3)., (©Rune Rasmussen, Mette Midttun, Tine Kolenda, Anne-Mette Ragle, Thea Winther Sørensen, Anders Vinther, Bo Zerahn, Maria Pedersen, Karsten Overgaard. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 02.03.2018.)

Introduction: People with Parkinson's disease (PD) are at risk of falling and have an increased risk of complications and prolonged recovery during hospitalisation., Objective: The aim of this study was to investigate the rate of complications and recovery related to a hip fracture in patients with PD., Methods: All patients with PD or dementia with Lewy bodies (DLB) and a hip fracture who were admitted from January 2013 through June 2014 (18 months) to the Department of Orthopaedics, Copenhagen University Hospital, Herlev, Denmark were evaluated. Data regarding duration of admission, complications, timing of administration of anti-PD medication, and level of mobility at discharge were obtained from files of patients with PD or DLB and compared with data from a comparable group of patients who were admitted with a hip fracture and chronic obstructive pulmonary disease (COPD)., Results: A total of 31 patients with PD or DLB (PD/DLB group) and 45 patients with COPD (COPD group) were registered during the timeframe investigated. The patients in the PD/DLB group were significantly (p < 0.05) younger than those in the COPD group (77.7 vs. 80.7 years, respectively) and had lower co-morbidity scores (0.9 vs 2.6, respectively). There were no significant differences in length of stay, delirium, or number of infections between the groups. Two thirds of patients with PD were not able to walk unassisted at discharge. Less than 50% of anti-PD medication was given within ±1 h of the scheduled time., Conclusions: Although patients with PD/DLB are significantly younger and have significantly lower degrees of co-morbidity than patients with COPD, their course and recovery after surgery are equivalent to those of patients with COPD. Patients with PD/DLB are at high risk of developing complications during hospital admission for hip fracture.

In this double-blind, randomised, controlled trial, we investigated the effects of vitamin C and E supplementation on endurance training adaptations in humans. Fifty-four young men and women were randomly allocated to receive either 1000 mg of vitamin C and 235 mg of vitamin E or a placebo daily for 11 weeks. During supplementation, the participants completed an endurance training programme consisting of three to four sessions per week (primarily of running), divided into high-intensity interval sessions [4-6 × 4-6 min; >90% of maximal heart rate (HRmax)] and steady state continuous sessions (30-60 min; 70-90% of HRmax). Maximal oxygen uptake (VO2 max ), submaximal running and a 20 m shuttle run test were assessed and blood samples and muscle biopsies were collected, before and after the intervention. Participants in the vitamin C and E group increased their VO2 max (mean ± s.d.: 8 ± 5%) and performance in the 20 m shuttle test (10 ± 11%) to the same degree as those in the placebo group (mean ± s.d.: 8 ± 5% and 14 ± 17%, respectively). However, the mitochondrial marker cytochrome c oxidase subunit IV (COX4) and cytosolic peroxisome proliferator-activated receptor-γ coactivator 1 α (PGC-1α) increased in the m. vastus lateralis in the placebo group by 59 ± 97% and 19 ± 51%, respectively, but not in the vitamin C and E group (COX4: -13 ± 54%; PGC-1α: -13 ± 29%; P ≤ 0.03, between groups). Furthermore, mRNA levels of CDC42 and mitogen-activated protein kinase 1 (MAPK1) in the trained muscle were lower in the vitamin C and E group than in the placebo group (P ≤ 0.05). Daily vitamin C and E supplementation attenuated increases in markers of mitochondrial biogenesis following endurance training. However, no clear interactions were detected for improvements in VO2 max and running performance. Consequently, vitamin C and E supplementation hampered cellular adaptations in the exercised muscles, and although this did not translate to the performance tests applied in this study, we advocate caution when considering antioxidant supplementation combined with endurance exercise.

Introduction: The purpose of the present study was to evaluate the use of R tests (event recorders) in geriatric patients examined at the Falls Clinic from March 2007 to September 2008, and to establish whether the use of R tests is relevant, is of clinical importance, results in overtreatment etc., Material and Methods: A total of 207 patients (62 men, and 145 women) were included. Their mean age was 82.8 years. All underwent R-test examination for 5-7 days. The R-test is programmed to store a certain number of arrhythmias and it also records a few seconds before and after the arrhythmia occurs. Furthermore, a pulse trend curve covering the entire period is recorded. A total of 20 minutes of arrhythmias may be stored, and battery capacity is at least eight days. The R-test is easily removed and put back in place as needed., Results: A total of 136 patients had a normal heart rhythm that did not explain their falls or lightheadedness. 34% needed adjustment of antiarrhythmics. 16.4% needed to see a cardiologist, 8.8% of these due to atrioventricular or sinoatrial block, 14.2% due to tachy-brady syndrome, 11.8% due to ventricular arrhythmias. Five patients were referred to a cardiology department for telemetry, four of these were provided with a pacemaker, another two patients were offered a pacemaker but rejected, six patients died., Conclusion: R-test examination for a period of 5-7 days is of great importance to the examination of geriatric fall patients, as 34% of patients needed adjustment of antiarrhythmics, and 16.7% needed to see a cardiologist. The R-test is easy to use and is well-tolerated by patients. The registration period needs to have a duration of at least 5-7 days when the purpose is to reveal seldom occurring, but invalidating arrhythmias in the elderly.

Aim: The aim of this study was to determine the effect of smoking a single cigarette on the blood flow rates in capillaries and arteriovenous anastomoses (AVAs) in light and heavy smokers in: a) the skin fold between the first and second fingers, and b) the pulp of the thumb., Methods: Five light (10-12 cigarettes/day) and 5 heavy (>20 cigarettes/day) chronic smokers participated (4 men and 6 women, median age 40.5 years). The blood flow rates were measured by the (133)Xenon local washout method (capillaries, skin fold) and the heat washout method (AVAs, thumb pulp), respectively, before, during, and after smoking of a single Prince cigarette (0.9 mg nicotine)., Results: The blood flow rate (f) in mL(100 g(min)(-1) [standard error, SE] in skin capillaries of light smokers was 24.4 [9], 8.9 [1.8], and 10.4 [3.3] before, during, and after smoking of one cigarette; in heavy smokers, f was 23.6 [10.9], 16.1 [5.3], and 7.1 [2.9]; f in pulp AVAs of light smokers was 130.6 [14.9], 49.2 [24.8], and 119.7 [20.9] before, during, and after smoking; in heavy smokers, the corresponding results were 134.4 [19.1], 136.2 [13.5], and 143 [15.3]. Thus, the blood flow rate in capillaries of both light and heavy smokers was higher before smoking the test cigarette than previously observed in non-smokers. In light smokers blood flow rate in AVAs decreased during smoking with a factor of 2.6, and it returned to the pre-smoking level immediately after the end of smoking the cigarette. In heavy smokers, f remained unchanged before, during, and after smoking., Conclusions: Smokers have severely disturbed peripheral microcirculation.