Patient case (clinical description): A 30-year-old man who is a computer scientist came to the clinic with the lab result stating azoospermia.  The patient is sexually active with his wife and does not use any contraception methods.  They have been trying to conceive for the past year with no success.  The patient has a past medical history of recurrent pneumonia, shortness of breath, and  persistent cough that produces large amounts of thick sputum. The patient had multiple lung infections during childhood. He does not smoke, use illicit drugs or alcohol.  The patient has no history of other medical conditions including allergies or any kind of surgery.  On physical examination, the digits show clubbing.  An ultrasound shows bilateral absence of the vas deferens, and FEV1 was 75% on the respiratory function test.

Patient's own account: I'm a 30-year-old computer scientist. I did some lab tests that came back quite alarming, stating that I have azoospermia?! I'm sexually active with my wife and we don't use contraception. We've been trying to have a child for the past year. I have a medical history of pneumonia and shortness of breath and regular wet cough. I had several lung infections when I was a kid. That's why I'm very careful and don't smoke, do drugs, or drink. I don't have other medical conditions including allergies or any kind of surgery. The doctor did the clubbing test on my fingers, which was positive. I also did an ultrasound and it showed that I'm missing the tubes that carry sperm around. I also had a 75% for my respiratory function test.

Clinical trial: Inspiratory Muscular Training

Eligibility criteria:
Inclusion Criteria:

          -  sedentary adults diagnosed with functional class II and II CHF in accordance with the
             New York Heart Association (NYHA);

          -  in stage B or C according to American College of Sports Medicine guidelines;

          -  with left ventricle ejection fraction lower than 45% (evaluated by echocardiogram in a
             period ≤ 1 year);

          -  cardiomegaly confirmed by increased left ventricle end-diastolic (LVDD) and
             end-systolic diameter (LVESD) associated with a cardiac index (CI) >0.5 according to
             chest X-rays;

          -  inspiratory muscle weakness (MIP <70% of predicted values);

          -  clinical stability with no change in medication for at least three months and
             sedentary (no regular physical activity performed in the previous six months or not
             accumulating 30 minutes or more of moderate physical activity - 3 to 6 METs - on most
             week days).

        Exclusion Criteria:

          -  patients exhibiting unstable angina, myocardial infarction or prior heart surgery up
             to three months before beginning the investigation;

          -  orthopedic, infectious or chronic metabolic diseases;

          -  treatment with steroids, hormones or chemotherapy;

          -  ratio between forced expiratory volume in one second and forced vital capacity
             (FEV1/FVC) < 70% of predicted, characterizing an obstructive respiratory disorder;

          -  respiratory diseases, smokers and ex-smokers with a history of cigarettes/day for more
             than 10 years.
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 21 Years old.
Subject must be at most 65 Years

Eligibility (NLI label): Contradiction