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Pubblicazioni recenti - cardiorespiratory
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An exercise-based educational and motivational intervention after surgery can improve behaviors, physical fitness and quality of life in bariatric patients.
PLoS One2020 ;15(10):e0241336. doi: 10.1371/journal.pone.0241336.
Gallé Francesca, Marte Gianpaolo, Cirella Assunta, Di Dio Mirella, Miele Alessandra, Ricchiuti Roberta, Liguori Fabrizio, Maida Pietro, Liguori Giorgio,
Abstract
INTRODUCTION:
Unhealthy lifestyles may hinder bariatric surgery outcomes. This non-randomized controlled study aimed to evaluate the effects of an integrated post-operative exercise-based educational and motivational program in improving behaviors, quality of life, anthropometric features, cardiorespiratory and physical fitness in bariatric patients respect to the only surgical intervention.
METHODS:
A group of adult sedentary bariatric patients chose to attend a 12-month exercise program integrated with diet education and motivational support, or to receive usual care. Dietary habits, binge eating disorder, physical activity, obesity-related quality of life, Body Mass Index, waist and hip circumference, VO2max, strength and flexibility were assessed at the start and at the end of the study in both groups.
RESULTS:
On a total of 82 patients enrolled, follow-up measures were obtained from 28 (85.7% females, mean age 38.2±8.7) and 42 (71.4% females, mean age 40.2±9.5) patients included in the intervention and control group, respectively. All the behavioral and physical outcomes improved significantly in the participants to the intervention, while the control group showed lesser changes, especially regarding quality of life and physical fitness.
CONCLUSIONS:
Notwithstanding the self-selection, these results suggest that a timely postoperative behavioral multidisciplinary program for bariatric patients may be effective in establishing healthy behaviors which can lead to better surgery outcomes.
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[Assessment of the nutritional status and physical condition of basic education students in Chile].
Nutr Hosp2020 Oct;():. doi: 10.20960/nh.03092.
Hernández Mosqueira Claudio Marcelo, Castillo Quezada Humberto Eugenio, Fernandes da Silva Sandro, Peña Troncoso Sebastian, Cresp Barría Mauricio Adrián, Cárcamo-Oyarzun Jaime, Martínez-Salazar Cristian, Caniuqueo Vargas Alexis, Fernandes Filho José,
Abstract
INTRODUCTION:
currently, regular physical exercise is the best tool available to promote people's well-being and improve their health.
OBJECTIVE:
the objective of the study was to determine the level of physical condition and nutritional status, as well as the relationship between them, in elementary school students in the city of Chillán.
METHODS:
the study is of the descriptive, cross-sectional, relational type. A total of 2500 students participated. To evaluate physical condition, the followingtests were used: Wells and Dillons (flexibility), Sargent Test (lower limb power), AAPHARD's 1-Mile Test (cardiorespiratory resistance), and Sit-ups in 30 seconds (localized muscular resistance).
RESULTS:
when comparing by sex, men presented significant statistical differences in the physical variables of aerobic capacity (p = 0.00), sit-ups (p = 0.00) and jumping (p = 0.00); only in the case of flexibility did women present better results (p = 0.01). When relating BMI to physical capacity a negative relationship is observed in both sexes-that is, the higher the BMI, the lower the amount of sit-ups (r = -0.032; r = -0.084, women and men, respectively) and aerobic capacity (r = -0.063 and r = -0.023, women and men, respectively). In flexibility and jump a positive though negligible correlation was observed.
CONCLUSION:
normal-weight men and women have a better physical condition as compared to those with overweight or obesity. As for sex, men have a better physical condition except for the flexibility test, where women obtain the best results. In addition, a negative relationship is observed in both sexes between physical condition and body composition, where a high BMI results in a low level of physical performance.
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Heart Rate Variability and Cardiovascular Adaptations Among Cancer-Survivors Following a 26-Week Exercise Intervention.
Integr Cancer Ther;19():1534735420969816. doi: 10.1177/1534735420969816.
Grote Silvie, Ricci Jeanette M, Dehom Salem, Modeste Naomi, Sealy Diadrey-Ann, Tarleton Heather P,
Abstract
Cardiotoxicity as a result of cancer treatment contributes to autonomic dysfunction and decreased cardiorespiratory fitness among cancer survivors. These deleterious cardiovascular outcomes reduce the survival prognosis for cancer patients and contribute to poor quality of life among survivors. Exercise interventions have been shown as effective in mitigating treatment-related side effects. However, previously published interventions have not explored the potential for improvement in autonomic dysfunction (heart rate variability, HRV). This study examined cardiovascular adaptations in cancer survivors (n?=?76) who participated in a 26-week intervention consisting of combined aerobic and resistance training (CART). The most noteworthy improvements occurred during the first 13?weeks of training and were maintained throughout the end of the 26-week period. HR improved from baseline (PRE) to the midpoint (MID) (?=?.036) and from PRE to POST timepoints (?=?.029). HRV and VO did not initially appear to change in response to CART. However, after stratification on time since treatment, participants who were 5 or more years from their last treatment experienced improvements (ie increase) in the HRV characteristic of HF power (?=?.050) and also in VO (?=.043), when compared to those experiencing less than 5?years of time since their last treatment. These findings highlight a need for more attention to address the cardiorespiratory deficits experienced by those who have recently completed cancer treatment. In conclusion, the CART intervention is effective in improving cardiorespiratory fitness and autonomic dysfunction. The structure of the intervention is feasible for cancer survivors to continue with at home, using minimal resources, and without supervision. This at-home model may be even more acceptable to recent survivors that may be homebound immediately following treatment.
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Effects of Linear Periodization Training on Performance Gains and Injury Prevention in a Garrisoned Military Unit.
J Mil Veterans Health2020 Jul;28(3):23-34.
Heard C, Willcox M, Falvo M, Blatt M, Helmer D,
Abstract
Purpose:
Performing well in combat requires military service members to be in peak physical shape. Although each branch of the United States military has fitness guidelines and assessments, there are no exact prescriptions for physical training programs. The absence of a standardised approach may lead to suboptimal physical performance and increased risk of musculoskeletal injury. To address this gap, we evaluated the feasibility of a pilot combat conditioning program based on linear periodisation.
Methods:
Twenty-nine garrisoned US Marine Corps service members (25 men, 4 women; 23.5±4.4 years) enrolled in our 11-week conditioning program that was supervised by a strength and conditioning professional. Military-specific (physical/combat fitness tests) and general (treadmill-based maximal exercise test) assessments were performed at baseline and 11 weeks. Training and injury logs were maintained throughout the duration of the program.
Results:
Approximately 80% (23/29) of service members completed the entire program. Cardiorespiratory fitness (Peak VO +8.10±10.9%; p=0.011), upper-body strength (pull-ups; +47.0±58.2%; p<0.001) and core strength (abdominal crunches; +9.2±23.3%; p=0.029) significantly increased from pre- to post-training. No statistically significant improvement or worsening was noted in any other performance assessment measure. Eight (28%) participants reported minor musculoskeletal concerns, of which only one required medical attention (injury rate 1.3 injuries/100 person-months).
Conclusion:
A protocolised linear periodisation training program was feasible and demonstrated improvements in fitness in a group of garrisoned Marines with low injury rates. Other military units may benefit from a similar approach.
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A Practical Guide to Resonance Frequency Assessment for Heart Rate Variability Biofeedback.
Front Neurosci2020 ;14():570400. doi: 10.3389/fnins.2020.570400.
Shaffer Fred, Meehan Zachary M,
Abstract
Heart rate variability (HRV) represents fluctuations in the time intervals between successive heartbeats, which are termed interbeat intervals. HRV is an emergent property of complex cardiac-brain interactions and non-linear autonomic nervous system (ANS) processes. A healthy heart is not a metronome because it exhibits complex non-linear oscillations characterized by mathematical chaos. HRV biofeedback displays both heart rate and frequently, respiration, to individuals who can then adjust their physiology to improve affective, cognitive, and cardiovascular functioning. The central premise of the HRV biofeedback resonance frequency model is that the adult cardiorespiratory system has a fixed resonance frequency. Stimulation at rates near the resonance frequency produces large-amplitude blood pressure oscillations that can increase baroreflex sensitivity over time. The authors explain the rationale for the resonance frequency model and provide detailed instructions on how to monitor and assess the resonance frequency. They caution that patterns of physiological change must be compared across several breathing rates to evaluate candidate resonance frequencies. They describe how to fine-tune the resonance frequency following an initial assessment. Furthermore, the authors critically assess the minimum epochs required to measure key HRV indices, resonance frequency test-retest reliability, and whether rhythmic skeletal muscle tension can replace slow paced breathing in resonance frequency assessment.
Copyright © 2020 Shaffer and Meehan.
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Effects of Anisodine Hydrobromide on the Cardiovascular and Respiratory Functions in Conscious Dogs.
Drug Des Devel Ther2020 ;14():4263-4276. doi: 10.2147/DDDT.S268113.
Liu Yunlu, Wang Lin, Wan Feng, Yang Na,
Abstract
Purpose:
Anisodine hydrobromide (Ani) is isolated from the medicinal plant for clinical use. Although considerable research regarding Ani has been reported, the safety profiles of Ani are currently unknown. This study investigated the cardiorespiratory effects of Ani in conscious dogs to provide clinicians a detailed safety profile of Ani on the cardiorespiratory system.
Materials and Methods:
Using the Latin square design, the study was divided into six phases, where in each phase, six telemetered beagle dogs received one dose of normal saline or sotalol hydrochloride or Ani (0.1, 0.4, 1.6, or 6.4 mg/kg). Electrocardiogram, blood pressure (BP) and respiratory parameters were collected before and after administration for 24 hours. Statistical comparisons were performed at scheduled time-points.
Results:
The heart rate was significantly increased, PR and QTV intervals were significantly shortened in Ani 0.4, 1.6, 6.4 mg/kg treatment group after drug administration. Compared with the saline group, a significant increase in heart rate and shortening of PR, QTV intervals were observed in the Ani 1.6, 6.4 mg/kg treatment groups from 5 min to 4 h time-points. Diastolic and mean BP were significantly increased in Ani 1.6, 6.4 mg/kg from 1 h to 2 h time-points compared to those of the saline control. Accelerated breathing was observed in the first 20 min after Ani 0.4, 1.6, and 6.4 mg/kg treatment, although not statistically significant. Furthermore, no significant differences were observed in any of the corresponding indexes of Ani 0.1 mg/kg treatment group at different time-points compared to those of the saline group.
Conclusion:
Ani may have adverse effects on the cardio-respiratory systems of dogs at doses above 0.4 mg/kg, whereas Ani 0.1 mg/kg was devoid of potentially deleterious effects on cardiorespiratory function.
© 2020 Liu et al.
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Effects of Self-selected Resistance Training on Physical Fitness and Psychophysiological Responses in Physically Inactive Older Women: A Randomized Controlled Study.
Percept Mot Skills2020 Oct;():31512520967610. doi: 10.1177/0031512520967610.
Elsangedy Hassan Mohamed, Oliveira Gledson Tavares Amorim, Machado Daniel Gomes da Silva, Tavares Marília Padilha Martins, Araújo Andressa de Oliveira, Krinski Kleverton, Browne Rodrigo Alberto Vieira, Gregório da Silva Sérgio,
Abstract
This study aimed to investigate the effects of a 12-week self-selected resistance training (SSRT) program on physical fitness and psychophysiological responses among physically inactive older women. We randomly allocated 32 inactive older women age?=?66.0 years, ?=?3.0) into either an SSRT (n?=?16) or control group (n?=?16). Participants performed SSRT three times per week over 12 weeks. We assessed maximal isotonic and isokinetic muscle strength, functional capacity, flexibility, cardiorespiratory fitness, and body composition at baseline and after the intervention. Affective responses and perceived exertion were evaluated after each exercise set throughout the training program. The SSRT group significantly improved their maximal muscle strength in all exercises (Cohen's d ranging from 1.4-3.3; all ?
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Metabolic and Cardiorespiratory Responses of Semiprofessional Football Players in Repeated Ajax Shuttle Tests and Curved Sprint Tests, and Their Relationship with Football Match Play.
Int J Environ Res Public Health2020 Oct;17(21):. doi: E7745.
Gabrys Tomasz, Stanula Arkadiusz, Szmatlan-Gabrys Urszula, Garnys Michal, Charvát Lubo?, Gupta Subir,
Abstract
In this study, the Ajax Shuttle Test (AST) and the Curved Sprint Test (CST) were conducted on semiprofessional football players to evaluate (1) their test performance, (2) the extent of anaerobic glycolysis by measuring blood lactate, (3) performance decrement and onset of fatigue, and (4) the correlation between selected physiological variables and test performance. Thirty-two semiprofessional Polish football players participated in this study. Both AST and CST were conducted on an outdoor football ground and were conducted in two sets; each set had six repetitions. In the case of AST, the total duration for 6 repetitions of the exercise in Sets 1 and 2 were 90.63 ± 3.71 and 91.65 ± 4.24 s, respectively, whereas, in the case of CST, the respective values were 46.8 ± 0.56 and 47.2 ± 0.66 s. Peak blood lactate concentration [La] after Sets 1 and 2 of AST were 14.47 ± 3.77 and 15.00 ± 1.85 mmol/L, and in the case of CST, the values were 8.17 ± 1.32 and 9.78 ± 1.35 mmol/L, respectively. Performance decrement in AST was more than in CST, both after Set 1 (4.32 ± 1.43 and 3.31 ± 0.96 in AST and CST, respectively) and Set 2 (7.95 ± 3.24 and 3.71 ± 1.02 in AST and CST, respectively). Only in a few of the repetitions, pulmonary ventilation (V) and oxygen uptake (VO) were found to be significantly correlated with the performance of the volunteers in both AST and CST. Respiratory exchange ratio (RER) was significantly correlated with most of the repetitions of AST, but not with CST. The study concludes that (1) AST shows more dependence on the anaerobic glycolytic system than shorter repetitive sprints (as in CST), (2) there is more performance decrement and fatigue in AST than in CST, and (3) early decrease in performance and fatigue in the semiprofessional football players in AST and CST may be due to the insufficiency of their aerobic energy system.
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Association between cardiorespiratory fitness and cardiometabolic risk factors in Brazilianchildren and adolescents: the mediating role of obesity parameters.
Paediatr Int Child Health2020 Oct;():1-10. doi: 10.1080/20469047.2020.1838758.
Brand Caroline, Reuter Cézane Priscila, Gaya Anelise Reis, Mota Jorge, Duncan Michael, Borfe Leticia, Pollo Renner Jane Dagmar,
Abstract
BACKGROUND:
There is a lack of clarity as to which obesity parameters may be more important in the association between cardiorespiratory fitness (CRF) and cardiometabolic risk factors (CMRF).
AIM:
To verify the mediating role of different obesity parameters on the association between CRF and CMRF in normal weight and overweight/obese children and adolescents.
METHODS:
This cross-sectional study comprised 999 children and adolescents (534 boys) aged 7-14 years from the south of Brazil. Body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and percentage of body fat were assessed. Participants were classified as normal weight, overweight and obese according to BMI. CRF was evaluated by the 6-minute run/walk test. . A continuous CMRF score was calculated by summing the Z-scores of the following variables: systolic and diastolic blood pressure, glucose, total cholesterol, high-density lipoprotein cholesterol and triglycerides. Data analysis was performed using partial correlation and linear regression models.
RESULTS:
BMI, WC, WHtR and percentage of body fat mediated the relationship between CRF and CMRF in overweight/obese boys and girls but not those of normal weight. Additionally, the percentage of the influence of each obesity parameter was 20% for BMI and WC, 16% for percentage of body fat and 18% for WHtR in girls. For boys, the mediation effect was 25% for BMI, 26% for WC, 28% for percentage of body fat and 25% for WHtR.
CONCLUSION:
Adiposity plays a central role in CMRF; therefore, maintaining an adequate weight status should be an important objective of health-promoting programmes in early age.
: CMRF, cardiometabolic risk factors; CRF, cardiorespiratory fitness; BMI. body mass index; HDL-c, high-density lipoprotein cholesterol, PROCESS PROESP-Br, Projeto Esporte Brasil; SPSS, Package for Social Sciences; TC, total cholesterol; TG, triglycerides; WC, waist circumference; WHtR, waist-to-height ratio; %BF, percentage of body fat.
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Physical activity interventions for people with congenital heart disease.
Cochrane Database Syst Rev2020 Oct;10():CD013400. doi: 10.1002/14651858.CD013400.pub2.
Williams Craig A, Wadey Curtis, Pieles Guido, Stuart Graham, Taylor Rod S, Long Linda,
Abstract
BACKGROUND:
Congenital heart disease (ConHD) affects approximately 1% of all live births. People with ConHD are living longer due to improved medical intervention and are at risk of developing non-communicable diseases. Cardiorespiratory fitness (CRF) is reduced in people with ConHD, who deteriorate faster compared to healthy people. CRF is known to be prognostic of future mortality and morbidity: it is therefore important to assess the evidence base on physical activity interventions in this population to inform decision making.
OBJECTIVES:
To assess the effectiveness and safety of all types of physical activity interventions versus standard care in individuals with congenital heart disease.
SEARCH METHODS:
We undertook a systematic search on 23 September 2019 of the following databases: CENTRAL, MEDLINE, Embase, CINAHL, AMED, BIOSIS Citation Index, Web of Science Core Collection, LILACS and DARE. We also searched ClinicalTrials.gov and we reviewed the reference lists of relevant systematic reviews.
SELECTION CRITERIA:
We included randomised controlled trials (RCT) that compared any type of physical activity intervention against a 'no physical activity' (usual care) control. We included all individuals with a diagnosis of congenital heart disease, regardless of age or previous medical interventions. DATA COLLECTION AND ANALYSIS: Two review authors (CAW and CW) independently screened all the identified references for inclusion. We retrieved and read all full papers; and we contacted study authors if we needed any further information. The same two independent reviewers who extracted the data then processed the included papers, assessed their risk of bias using RoB 2 and assessed the certainty of the evidence using the GRADE approach. The primary outcomes were: maximal cardiorespiratory fitness (CRF) assessed by peak oxygen consumption; health-related quality of life (HRQoL) determined by a validated questionnaire; and device-worn 'objective' measures of physical activity.
MAIN RESULTS:
We included 15 RCTs with 924 participants in the review. The median intervention length/follow-up length was 12 weeks (12 to 26 interquartile range (IQR)). There were five RCTs of children and adolescents (n = 500) and 10 adult RCTs (n = 424). We identified three types of intervention: physical activity promotion; exercise training; and inspiratory muscle training. We assessed the risk of bias of results for CRF as either being of some concern (n = 12) or at a high risk of bias (n = 2), due to a failure to blind intervention staff. One study did not report this outcome. Using the GRADE method, we assessed the certainty of evidence as moderate to very low across measured outcomes. When we pooled all types of interventions (physical activity promotion, exercise training and inspiratory muscle training), compared to a 'no exercise' control CRF may slightly increase, with a mean difference (MD) of 1.89 mL/kg/min (95% CI -0.22 to 3.99; n = 732; moderate-certainty evidence). The evidence is very uncertain about the effect of physical activity and exercise interventions on HRQoL. There was a standardised mean difference (SMD) of 0.76 (95% CI -0.13 to 1.65; n = 163; very low certainty evidence) in HRQoL. However, we could pool only three studies in a meta-analysis, due to different ways of reporting. Only one study out of eight showed a positive effect on HRQoL. There may be a small improvement in mean daily physical activity (PA) (SMD 0.38, 95% CI -0.15 to 0.92; n = 328; low-certainty evidence), which equates to approximately an additional 10 minutes of physical activity daily (95% CI -2.50 to 22.20). Physical activity and exercise interventions likely result in an increase in submaximal cardiorespiratory fitness (MD 2.05, 95% CI 0.05 to 4.05; n = 179; moderate-certainty evidence). Physical activity and exercise interventions likely increase muscular strength (MD 17.13, 95% CI 3.45 to 30.81; n = 18; moderate-certainty evidence). Eleven studies (n = 501) reported on the outcome of adverse events (73% of total studies). Of the 11 studies, six studies reported zero adverse events. Five studies reported a total of 11 adverse events; 36% of adverse events were cardiac related (n = 4); there were, however, no serious adverse events related to the interventions or reported fatalities (moderate-certainty evidence). No studies reported hospital admissions.
AUTHORS' CONCLUSIONS:
This review summarises the latest evidence on CRF, HRQoL and PA. Although there were only small improvements in CRF and PA, and small to no improvements in HRQoL, there were no reported serious adverse events related to the interventions. Although these data are promising, there is currently insufficient evidence to definitively determine the impact of physical activity interventions in ConHD. Further high-quality randomised controlled trials are therefore needed, utilising a longer duration of follow-up.
Copyright © 2020 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
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Nasopharyngeal nephroblastoma in a 3-month-old Boer goat.
J Vet Diagn Invest2020 Oct;():1040638720969698. doi: 10.1177/1040638720969698.
Athey Jillian M, Rice Laura E, Harvey Aja B, Washburn Kevin E, Rodrigues-Hoffmann Aline,
Abstract
A 3-mo-old, female Boer goat was presented because of respiratory difficulties. Tachypnea and inspiratory dyspnea were noted during physical examination. Thoracic radiographs were unremarkable; however, upper airway and nasal passage radiographs revealed a soft tissue mass within the nasal passages. The patient underwent cardiorespiratory arrest and did not respond to resuscitation efforts during endoscopy. A large, pedunculated, semi-firm mass originated from the soft palate and obstructed 90% of the nasopharynx on autopsy. Histologically, the mass was composed of primitive cells that multifocally formed tubules and glomeruloid structures intermingled with areas of fusiform and blastemal cells. The neoplastic cells were positive for cytokeratin (tubular and glomeruloid cells), vimentin (fusiform population and blastemal cells), and Wilms tumor 1 protein (glomeruloid structures) on immunohistochemistry, consistent with a triphasic nephroblastoma. To our knowledge, nasopharyngeal nephroblastoma has not been reported previously in any species.
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Is the Obesity Paradox in Heart Failure Dependent on Cardiorespiratory Fitness?
Arq Bras Cardiol2020 Oct;115(4):646-648. doi: S0066-782X2020001200646.
Laukkanen Jari A, Kunutsor Setor K,
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Impact of Cardiorespiratory Fitness on the Obesity Paradox in Heart Failure with Reduced Ejection Fraction.
Arq Bras Cardiol2020 Oct;115(4):639-645. doi: S0066-782X2020001200639.
Moreira Rita Ilhão, Silva Tiago Pereira, Gonçalves António Valentim, Feliciano Joana, Rio Pedro, Soares Rui, Ferreira Rui Cruz,
Abstract
BACKGROUND:
Higher body mass index (BMI) has been associated with improved outcomes in heart failure with reduced ejection fraction. This finding has led to the concept of the obesity paradox.
OBJECTIVE:
To investigate the impact of exercise tolerance and cardiorespiratory capacity on the obesity paradox.
METHODS:
Outpatients with symptomatic heart failure and left ventricular ejection fraction (LVEF) ? 40%, followed up in our center, prospectively underwent baseline comprehensive evaluation including clinical, laboratorial, electrocardiographic, echocardiographic, and cardiopulmonary exercise testing parameters. The study population was divided according to BMI (< 25, 25 - 29.9, and ? 30 kg/m2). All patients were followed for 60 months. The combined endpoint was defined as cardiac death, urgent heart transplantation, or need for mechanical circulatory support. P value < 0.05 was considered significant.
RESULTS:
In the 282 enrolled patients (75% male, 54 ± 12 years, BMI 27 ± 4 kg/m2, LVEF 27% ± 7%), the composite endpoint occurred in 24.4% during follow-up. Patients with higher BMI were older, and they had higher LVEF and serum sodium levels, as well as lower ventilatory efficiency (VE/VCO2) slope. VE/VCO2 and peak oxygen consumption (pVO2) were strong predictors of prognosis (p < 0.001). In univariable Cox regression analysis, higher BMI was associated with better outcomes (HR 0.940, CI 0.886 - 0.998, p 0.042). However, after adjusting for either VE/VCO2 slope or pVO2, the protective role of BMI disappeared. Survival benefit of BMI was not evident when patients were grouped according to cardiorespiratory fitness class (VE/VCO2, cut-off value 35, and pVO2, cut-off value 14 mL/kg/min).
CONCLUSION:
These results suggest that cardiorespiratory fitness outweighs the relationship between BMI and survival in patients with heart failure.
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The use of serious games as an innovative educational strategy for learning cardiopulmonary resuscitation: an integrative review.
Rev Gaucha Enferm2020 ;41():e20190293. doi: S1983-14472020000100511.
Siqueira Tainá Vilhar, Nascimento Juliana da Silva Garcia, Oliveira Jordana Luiza Gouvêa de, Regino Daniela da Silva Garcia, Dalri Maria Celia Barcellos,
Abstract
OBJECTIVE:
To analyze the scientific evidence available in literature on the use of serious games for health students to learn about cardiopulmonary resuscitation.
METHODS:
Integrative review in PubMed / MEDLINE®, LILACS, Scopus and CINAHL databases. Included primary studies, in Portuguese, English or Spanish, from January 2009 to August 2019. The Rayyan software was used for study selection.
RESULTS:
We identified 115 studies, and 8 composed the sample, categorizing two domains: : Intention of the study with regard to cardiopulmonary resuscitation through the serious game, and method used by the serious game to teach CPR.
CONCLUSION:
Medical students are the main audience for serious game learning, and the main intentions of the games are to compare their effectiveness with traditional methodologies and knowledge retention. The method adopted is the description of a cardiorespiratory arrest for training. The serious game proved effective for learning cardiopulmonary resuscitation.
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Physical Activity and Heart Failure: Taking Steps to Control a Major Public Health Burden.
Am J Lifestyle Med;14(6):555-570. doi: 10.1177/1559827618769609.
LaMonte Michael J,
Abstract
Heart failure (HF) is a complex clinical syndrome that is increasingly prevalent among US adults and accounts for substantial burden of healthcare costs and morbidity. HF is commonly associated with prior myocardial infarction as well as prolonged exposure to hypertension, diabetes, and coronary atherosclerosis. Exercise training is becoming established in the management of HF because of its beneficial effect on both central (cardiac) and peripheral (skeletal muscle) HF mechanisms. The role of habitual physical activity in the primary prevention of HF is less clear. Recent prospective observational studies suggest there is lower risk of developing HF in adults who are more physically activity and have higher cardiorespiratory fitness compared with their less active and fit peers. This article reviews the published evidence on physical activity and HF prevention, discusses potential mechanisms for this benefit, and suggests areas where further research is needed to establish recommendations on the type, amount, and intensity of physical activity required to prevent occurrence of HF.
© 2018 The Author(s).
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Acute and chronic effects of combined exercise on ambulatory blood pressure and its variability in hypertensive postmenopausal women.
Chin J Physiol;63(5):227-234. doi: 10.4103/CJP.CJP_61_20.
Matias Larissa Aparecida Santos, Mariano Igor Moraes, Batista Jaqueline Pontes, de Souza Tállita Cristina Ferreira, Amaral Ana Luiza, Dechichi Juliene Gonçalves Costa, de Lima Rodrigues Mateus, Carrijo Victor Hugo Vilarinho, Cunha Thulio Marquez, Puga Guilherme Morais,
Abstract
The aim of this study was to investigate the acute and chronic effects, and their correlation, after combined aerobic and resistance exercises in blood pressure (BP) and its variability (BPV) in hypertensive postmenopausal women. Fourteen hypertensive postmenopausal women monitored BP at rest and during 24 h by ambulatory BP monitoring in a control day without exercise performance a pretraining (baseline), after an acute exercise session (acute), and after a chronic exercise training for 10 weeks (chronic). After exercise training, systolic BP (SBP, ? = -150 mmHg.24 h), diastolic BP (DBP, ? = -96 mmHg.24 h), and mean BP (MBP, ? = -95 mmHg.24 h) area under the curve were smaller than baseline measurements (P < 0.05) with no difference between acute and baseline measurements. The SBP (?SD = -2, ?SD = -1.7, and ?ARV = -1.9 mmHg), DBP (?SD = -0.9, ?SD = -0.8, and ?ARV = -0.9 mmHg), and MBP (?SD = -1.5, ?SD = -1.3, and ?ARV = -1.2 mmHg) variability reduced in acute session in relation to baseline, with no chronic effects. There are moderate correlations between acute and chronic responses in wake SBP, sleep DBP, and SD. In conclusion, combined exercise reduces ambulatory BP chronically but not acutely. In contrast, BPV decreases after an acute session but not chronically. Awake SBP, sleep DBP, and SDindices are promising candidates to predict individual cardiovascular responses to exercise.
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Arterial Stiffness and Cardiorespiratory Fitness Are Associated With Cognitive Function in Older Adults.
Behav Med2020 Oct;():1-12. doi: 10.1080/08964289.2020.1825921.
Mason Justin R, Tenenbaum Gershon, Jaime Salvador, Roque Nelson, Maharaj Arun, Figueroa Arturo,
Abstract
Age-related cognitive impairment has been associated with arterial stiffening and decreased cardiorespiratory fitness. The aims of this cross-sectional study were to compare cognitive function domains and cardiovascular parameters in older adults (? 65?years old) with high and normal aortic stiffness (via carotid-femoral pulse wave velocity, cfPWV) and to explore relationships among cfPWV, carotid intima-media thickness, cardiorespiratory fitness, and cognitive function. Vascular and cognitive function were measured in older adults with either normal or high cfPWV. Cognitive function was measured via an intensive one-time neuropsychological battery, while cfPWV by applanation tonometry, carotid intima-media thickness and function (i.e., distensibility) by ultrasonography, and cardiorespiratory fitness (i.e., VOpeak) by a submaximal exercise test. Correlations among age, VOpeak, carotid intima-media thickness, cfPWV, and cognitive function were performed along with a series of multivariate analyses of variance. Compared with NAS, participants with HAS had greater aortic, carotid, and brachial blood pressures but similar cardiorespiratory fitness and carotid intima-media thickness and distensibility. Participants with NAS exhibited better neuropsychological performance in executive function and attention and overall cognitive function than those with HAS. When controlling for age, visual scanning and perception scores were correlated with cfPWV and VOpeak. Our findings suggest that certain cognitive domains for older adults are associated with their cardiorespiratory fitness and aortic stiffness.
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Effects of a priming dose of alfaxalone on the total anesthetic induction dose for and cardiorespiratory function of sedated healthy cats.
Am J Vet Res2020 Nov;81(11):850-855. doi: 10.2460/ajvr.81.11.850.
Lagos-Carvajal Angie, Queiroz-Williams Patricia, Cremer Jeannette, Ricco Pereira Carolina H, Nevarez Javier, da Cunha Anderson F, Liu Chin-Chi,
Abstract
OBJECTIVE:
To investigate the effects of a priming dose of alfaxalone on the total anesthetic induction dose for and cardiorespiratory function of sedated healthy cats.
ANIMALS:
8 healthy adult cats.
PROCEDURES:
For this crossover study, cats were sedated with dexmedetomidine and methadone administered IM. Cats next received a priming induction dose of alfaxalone (0.25 mg/kg, IV) or saline (0.9% NaCl) solution (0.025 mL/kg, IV) over 60 seconds and then an induction dose of alfaxalone (0.5 mg/kg/min, IV) until orotracheal intubation was achieved. Cardiorespiratory variables were recorded at baseline (immediately prior to priming agent administration), immediately after priming agent administration, after orotracheal intubation, and every 2 minutes until extubation. The total induction dose of alfaxalone was compared between the 2 priming agents.
RESULTS:
Mean ± SD total anesthetic induction dose of alfaxalone was significantly lower when cats received a priming dose of alfaxalone (0.98 ± 0.28 mg/kg), compared with when cats received a priming dose of saline solution (1.41 ± 0.17 mg/kg). Mean arterial blood pressure was significantly higher when alfaxalone was used as the priming dose. No cats became apneic or had a hemoglobin oxygen saturation of < 90%. Expired volume per minute was not significantly different between the 2 priming agents.
CONCLUSIONS AND CLINICAL RELEVANCE:
Administration of a priming dose of alfaxalone to healthy sedated cats reduced the total dose of alfaxalone needed to achieve orotracheal intubation, maintained mean arterial blood pressure, and did not adversely impact the measured respiratory variables.
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Nocturnal Arrhythmias and Heart-Rate Swings in Patients With Obstructive Sleep Apnea Syndrome Treated With Beta Blockers.
J Am Heart Assoc2020 Oct;():e015926. doi: 10.1161/JAHA.120.015926.
Lombardi Carolina, Faini Andrea, Mariani Davide, Gironi Federica, Castiglioni Paolo, Parati Gianfranco,
Abstract
Background The higher cardiovascular variability and the increased prevalence of arrhythmias in patients with obstructive sleep apneas may contribute to their higher rate of fatal events during sleep. In this regard, the use of beta blockers (BB) is debated because they may induce bradyarrhythmias and alter the pattern of heart rate changes induced by apneas. Thus, the aim of our study is to quantify peri-apneic heart-rate swings and prevalence of nocturnal bradyarrhythmias in BB-treated and BB-naïve patients with obstructive sleep apnea. Methods and Results Our real-life, retrospective, cohort study analyzed data from patients with obstructive sleep apnea after a basal cardiorespiratory polysomnography. Among 228 eligible participants, we enrolled 78 BB-treated and 88 BB-naïve patients excluding those treated with antiarrhythmic drugs or pacemakers, or with uninterpretable ECG traces during polysomnography. In each patient, type and frequency of arrhythmias were identified and peri-apneic changes of RR intervals were evaluated for each apnea. BB-treated patients were older and with more comorbidities than BB-naïve patients, but had similar obstructive sleep apnea severity, similar frequency of arrhythmic episodes, and similar prevalence of bradyarrhythmias. Apnea-induced heart-rate swings, unadjusted for age, showed lower RR interval changes in BB-treated (133.5±63.8 ms) than BB-naïve patients (171.3±87.7 ms, =0.01), lower RR interval increases during apneas (58.5±28.5 versus 74.6±40.2 ms, =0.01), and lower RR interval decreases after apneas (75.0±42.4 versus 96.7±55.5 ms, <0.05). Conclusions BB appear to be safe in patients with obstructive sleep apnea because they are not associated with worse episodes of nocturnal bradyarrhythmias and even seem protective in terms of apnea-induced changes of heart rate.
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High-intensity interval training in the prehabilitation of cancer patients-a systematic review and meta-analysis.
Support Care Cancer2020 Oct;():. doi: 10.1007/s00520-020-05834-x.
Palma Stefano, Hasenoehrl Timothy, Jordakieva Galateja, Ramazanova Dariga, Crevenna Richard,
Abstract
PURPOSE:
To evaluate the impact of high-intensity interval training (HIIT) on health-related outcome parameters in the prehabilitation of patients diagnosed with cancer.
METHODS:
A systematic review and meta-analysis of comparative studies on HIIT in cancer prehabilitation conducted by screening standard databases from their inception to March 30, 2020. Outcomes of interest included cardiorespiratory fitness, feasibility, safety, clinical, and patient-reported outcomes.
RESULTS:
Of the 855 identified studies, 8 articles met the inclusion criteria (7 randomized, 1 non-randomized controlled trial) with a total of 896 patients. The study protocols were heterogeneous, but the methodological quality ranged from good to high according to PEDro scale. Meta-analysis revealed a significant improvement of peak oxygen consumption (VOpeak) achieved with HIIT compared to usual care. Furthermore, HIIT was feasible and safe, showing low risk of adverse events and positive effects on health-related outcomes in prehabilitative settings.
CONCLUSION:
In the phase of prehabilitation, HIIT has potential health benefits in patients diagnosed with cancer and is feasible and safe to perform. Nonetheless, larger randomized controlled trials focusing on long-term effects (such as cancer recurrence or survival rates) are missing, to underline the potential relevance of HIIT for cancer patients.
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