Periodized combined training in physically active overweight women over 50 years

Abstract Aim: This quasi-experimental study, analyzes if periodized combined training's influence on plasma cytokine levels, muscle strength, and cardiorespiratory fitness in physically active women with overweight and/or obesity over 50 years. Methods: The sample was composed of 33 physically active women who were randomly allocated to three groups: Non-Periodized (NP) (n = 11); Undulating Periodization (UP) (n = 9); and Flexible Undulating Periodization (FUP) (n = 13). This study was conducted for 17 weeks, which included adaptation (weeks 1-3), baseline testing (week 4), training program (weeks 5-16), and post-evaluation (week 17). The training frequency comprised of three weekly sessions, with 30 min of aerobic exercise and 45 min of strength exercises. The data were analyzed using descriptive statistics and analysis of variance. The level of significance was p ≤ 0.05. Results: No differences were observed in weight parameters, plasma levels of cytokines, and biochemical parameters in any group, before and after the completion of the training period. Participants demonstrated increase in strength of the upper limbs in the UP (p = 0.032) and FUP (p = 0.021) groups, an increase in aerobic fitness in the NP (p = 0.041) and UP (p = 0.005) groups, and an increase in the amount of time of vigorous activity per week in the NP group (p = 0.019). Conclusion: This study shows that periodized combined training in physically active women with overweight and/or obesity over 50 years proved to be beneficial for all groups; although, the UP group exhibited better performance.

Effect of combined exercise training on heart rate variability in normotensive and hypertensive postmenopausal women

Abstract Aim: This study aimed to verify and compare the effects of 10 weeks of combined exercise training on the heart rate variability of normotensive (NT) and hypertensive (HT) postmenopausal women. Methods: This is a quasi-experimental controlled clinical trial. Therefore, 14 HT and 12 NT postmenopausal women completed 10 weeks of combined exercise training. The exercise protocol consisted of 45 min of exercise, performed 3 times a week, consisting of 5 min of warm-up, 20 min of resistance exercise, and 20 min of aerobic exercise. Heart rate variability assessments were performed before and after the end of physical training. Results: Heart rate variability was assessed pre- and post-training periods. Mean RR (δNT = 95 ± 88; δHT = 38 ± 127), SDNN (δNT = 9 ± 13; δHT = 3 ± 14), RMSSD (δNT = 10 ± 12; δHT = 2 ± 18), SD1 (δNT = 7 ± 8; δHT = 1 ± 13), and SD2 (δNT = 10 ± 18; δHT = 4 ± 17) showed improvements after the intervention (time effects p < 0.05). No parameters presented group or interaction effects (p ≥ 0.05). Conclusion: In summary, 10 weeks of combined exercise training improved heart rate variability parameters similarly in both NT and HT postmenopausal women. Therefore, combined exercise training may be used to improve autonomic modulation of the heart rate of postmenopausal women, regardless of the presence of hypertension.

Educational intervention to improve the competence of Mexican physicians to provide nutritional management for diabetes mellitus type 2 / Intervención educativa para mejorar la competencia de médicos mexicanos para manejar nutricionalmente diabetes mellitus Tipo 2

ABSTRACT Objective To evaluate the effect of a participative educational intervention on the clinical competence of Mexican family physicians regarding the nutritional management of patients with diabetes mellitus Type 2. Materials and Methods Quasi-experimental study with a before-and-after control group. Convenience sample included 60 family physicians distributed in two social security primary health care units, randomly selected: 30 in the "A" unit and 30 in the "B" unit. Unit "A" was assigned randomly as control group, and "B" unit as intervention group. The intervention consisted of a theoretical-practical course-workshop that lasted six months where real cases were discussed and solved. Clinical competence was evaluated by means of an instrument designed ex professo, with a maximum theoretical value of 100 and 94% reliability according to the Kuder-Richardson test. Medians of clinical competence were compared among groups, before and after intervention, using the Mann-Whitney U test, while frequencies distribution of clinical competence level were analyzed with the Kolmogorov-Smirnov test (p≤0.05). Results Overall medians and intervals for unit "A" were 28 (9-45) pre-intervention and 34 (11-51) pos-intervention, with before-after difference p>0.05; for unit "B", values were 32 (12-50) pre-intervention, 61 (36-82) pos-intervention, and before-after difference p≤0.05. No significant differences were found among groups pre-intervention (p>0.05), although they were observed pos-intervention (p≤0.05). Conclusions The educational intervention evaluated proved to improve, in a statistically significant way, the overall and by dimensions clinical competence level of Mexican family physicians for nutritional management of patients with diabetes mellitus type 2.(AU)

RESUMEN Objetivo Evaluar el efecto de una intervención educativa participativa sobre la competencia clínica de médicos familiares mexicanos para el manejo nutricio de pacientes con diabetes mellitus Tipo 2. Método Estudio cuasiexperimental con grupo control antes-después. Se estudió una muestra por conveniencia de 60 médicos familiares distribuidos en dos unidades médicas de atención primaria de seguridad social elegidas al azar, 30 en la "A" y 30 en la "B". La unidad "A" fue designada grupo control, y la "B" de intervención. La intervención consistió en un curso-taller teórico-práctico que duró seis meses, donde se discutieron y resolvieron casos reales. La competencia clínica se evaluó mediante un instrumento diseñado ex professo, con un valor teórico máximo de 100, y una fiabilidad de 94% según prueba de Kuder-Richardson. Se compararon las medianas de competencia clínica entre grupos antes y después mediante la prueba U de Mann-Whitney, y cinco las distribuciones de frecuencias de los niveles de competencia clínica mediante la prueba de Kolmogórov-Smirnov (p≤0,05). Resultados Medianas e intervalos de la calificación global: unidad "A" 28 (9-45) pre-intervención, 34 (11-51) pos-intervención, diferencia antes-después p≤0,05; unidad "B" 32 (12-50) pre-intervención, 61 (36-82) pos-intervención, diferencia antes-después p≤0,05. No se encontró diferencia significativa entre los grupos pre-intervención (p>0,05), y si pos-intervención (p≤0,05). Conclusiones La intervención educativa evaluada demostró mejorar, de forma estadísticamente significativa, el nivel de competencia clínica global y por dimensión, de médicos familiares mexicanos para el manejo nutricio de pacientes con diabetes mellitus tipo 2.(AU)

Seguimiento e impacto de la divulgación de cinco alertas sanitarias de medicamentos en f1Colombia / Monitoring and impact of the disclosure of five health alerts for drugs in Colombia

RESUMEN Objetivo Realizar la notificación y verificar el seguimiento de cinco alertas sanitarias de medicamentos a un grupo de prestadores de salud en Colombia. Métodos Estudio cuasi-experimental, prospectivo, antes y después, sin grupo control, mediante una intervención en médicos prescriptores de ketoconazol, metoclopramida, nimesulida, diacereina, ranelato de estroncio. Se tomó como población universo a los afiliados al régimen contributivo del Sistema de Salud Colombiano en 13 entidades promotoras de salud (EPS) de Colombia. Se identificaron los pacientes que recibían mensualmente estos medicamentos previamente a la alerta. Se realizó una intervención educativa y posteriormente se midió la proporción de cambio en la dispensación. Resultados Se realizaron en total unas 26 actividades diferentes a 500 médicos prescriptores. De un total de 4 121 954 de personas se identificaron 13 979 pacientes mensuales en 2013 que recibían alguno de los cinco medicamentos y se observó una reducción en 1 470 sujetos al mes (-10,5%) para 2014. El medicamento con el que se consiguió la mayor reducción fue ketoconazol (-31,1% de casos), seguido de ranelato de estroncio (-30,3%) y metoclopramida (-8,6%). Para nimesulida (+0,7%) y diacereina (+16,4%) no se obtuvieron resultados favorables. Conclusiones Se mantienen prescripciones potencialmente riesgosas en pacientes de Colombia. Con intervenciones basadas en farmacovigilancia posterior al reporte de alertas por agencias reguladoras sanitarias, se puede disminuir la proporción de pacientes que utilizan estos medicamentos.(AU)

ABSTRACT Objective Make the notification and monitoring compliance with five health drug alerts to a group of health care providers in Colombia. Methods Quasi-experimental, prospective, before-after study, without control group, by intervening in physician prescribers of ketoconazole, metoclopramide, nimesulide, diacerein, strontium ranelate. The affiliated population of the contributory system of the Colombian Health System was taken as the universe population sample from 13 health promoting entities (EPS) of Colombia. Patients receiving monthly these drugs prior to the alert were identified. An educational intervention was performed and then the rate of change in the dispensation was measured. Results About 26 different activities were conducted on 500 prescribers. Out of a total of 4 121 954 people, 13 979 patients were identified monthly in 2013, who received some of the five medications. Likewise, a reduction in 1,470 subjects per month (-10.5%) for 2014 was observed. The drug which achieved the greatest reduction was ketoconazole (-31.1% of cases), followed by strontium ranelate (-30.3%) and metoclopramide (-8.6%). For nimesulide (+ 0.7%) and diacerein (+ 16.4%) no favorable results were obtained. Conclusions Patients with potentially risky prescriptions remain in Colombia; educational pharmacovigilance interventions made after the report alerts given by drug regulatory agencies may decrease the proportion of patients using these drugs.(AU)