Does Heavy-Resistance Training Improve Mobility and Perception of Quality of Life in Older Women?

Regular physical exercise has shown great benefits in preventing age-related functional losses and in improving the perception of health-related quality of life (HRQoL) in older people. To optimize these benefits, it would be interesting to evaluate what type of exercise is better. Therefore, the purpose of this study was to assess the effects of heavy-resistance training on mobility and HRQoL in older women. Forty healthy, untrained older women (60−75 years) were randomly assigned to three groups: circuit resistance training (CRT, n = 15), traditional resistance training (TRT, n = 15) or the control group (CG, n = 10). During the 12-week training period, both experimental groups performed training with heavy loads, twice a week. Before and after the training period, the Timed Up and Go test, as a proxy of mobility, and the perception of HRQoL were evaluated. TRT and CRT resulted in a statistically significant improvement in the Timed Up and Go test (−5.4 and −10.3%, respectively; p < 0.05), but only the improvement after CRT was significantly greater than changes in the CG (p < 0.001). Only CRT elicited improvements in several dimensions of the perception of the HRQoL questionnaire, such as: physical functioning (13%, p < 0.001), general health (8.1%; p = 0.048), vitality (17.7%; p < 0.001), role emotional (6.7%; p = 0.044) and physical component summary (6.3%; p = 0.001). The change in the CRT group was greater than in the CG (p < 0.001) in the physical functioning score. The present findings show that CRT might be a time- (and hence cost-) effective alternative to trigger multiple positive functional and psychological adaptations in older women.

Trombo sobre la red de Chiari: Thrombus on Chiari Network

El descubrimiento de una masa en la aurícula derecha obliga a realizar un amplio diagnóstico diferencial que incluye tumores, vegetaciones, trombo, válvula de Eustaquio o red de Chiari. Tradicionalmente, estas posibilidades etiológicas se han considerado excluyentes. En esta presentación se describe el caso de un varón con cuadro catarral, dolorimiento generalizado y febrícula, con diagnóstico de fibrilación auricular y, mediante ecocardiograma, de una masa alargada muy móvil en la aurícula derecha. Se plantearon diferentes entidades etiológicas y finalmente se inició tratamiento con heparina, con lo que se produjo la resolución de dicha masa, con persistencia de una estructura filamentosa compatible con la red de Chiari.

The presence of a mass in the right atrium requires a broad differential diagnosis including tumors, vegetations, thrombus, Eustachian valve, or Chiari network. Traditionally, these etiological possibilities have been considered exclusive. This report describes the case of a male patient with catarrh, generalized tenderness and low-grade fever, diagnosed with atrial fibrillation. An echocardiography revealed a mobile, elongated mass in the right atrium. Different etiological entities were posed, and finally heparin treatment was started which resolved the mass, with a persistent filamentous structure compatible with Chiari network.

Trombo sobre la red de Chiari: Thrombus on Chiari Network

El descubrimiento de una masa en la aurícula derecha obliga a realizar un amplio diagnóstico diferencial que incluye tumores, vegetaciones, trombo, válvula de Eustaquio o red de Chiari. Tradicionalmente, estas posibilidades etiológicas se han considerado excluyentes. En esta presentación se describe el caso de un varón con cuadro catarral, dolorimiento generalizado y febrícula, con diagnóstico de fibrilación auricular y, mediante ecocardiograma, de una masa alargada muy móvil en la aurícula derecha. Se plantearon diferentes entidades etiológicas y finalmente se inició tratamiento con heparina, con lo que se produjo la resolución de dicha masa, con persistencia de una estructura filamentosa compatible con la red de Chiari.(AU)

The presence of a mass in the right atrium requires a broad differential diagnosis including tumors, vegetations, thrombus, Eustachian valve, or Chiari network. Traditionally, these etiological possibilities have been considered exclusive. This report describes the case of a male patient with catarrh, generalized tenderness and low-grade fever, diagnosed with atrial fibrillation. An echocardiography revealed a mobile, elongated mass in the right atrium. Different etiological entities were posed, and finally heparin treatment was started which resolved the mass, with a persistent filamentous structure compatible with Chiari network.(AU)

Impact of resistance circuit training on neuromuscular, cardiorespiratory and body composition adaptations in the elderly.

Declines in maximal aerobic power and skeletal muscle force production with advancing age are examples of functional declines with aging, which can severely limit physical performance and independence, and are negatively correlated with all cause mortality. It is well known that both endurance exercise and resistance training can substantially improve physical fitness and health-related factors in older individuals. Circuit-based resistance training, where loads are lifted with minimal rest, may be a very effective strategy for increasing oxygen consumption, pulmonary ventilation, strength, and functional capacity while improving body composition. In addition, circuit training is a time-efficient exercise modality that can elicit demonstrable improvements in health and physical fitness. Hence, it seems reasonable to identify the most effective combination of intensity, volume, work to rest ratio, weekly frequency and exercise sequence to promote neuromuscular, cardiorespiratory and body composition adaptations in the elderly. Thus, the purpose of this review was to summarize and update knowledge about the effects of circuit weight training in older adults and elderly population, as a starting point for developing future interventions that maintain a higher quality of life in people throughout their lifetime.

Characteristics of culprit atheromatous plaques obtained in vivo by intravascular ultrasound radiofrequency analysis: results from the CULPLAC study.

OBJECTIVES: We used virtual histology-intravascular ultrasound (VH-IVUS) to investigate the characteristics of culprit lesions in acute coronary syndromes (ACS). BACKGROUND: Autopsy studies of patients who died of ACS have shown that culprit atheromatous plaques almost always contain a large lipid-necrotic core covered by a ruptured thin fibrous cap. There are no studies of sufficient size that have assessed the in vivo characterization of plaques responsible for ACS. METHODS: Patients undergoing angiography for stable ischemic heart disease and ACS (with and without ST-segment elevation) were enrolled in a prospective study. Lesions in patients with stable angina were classified as stable and those in patients with ACS as culprit or nonculprit. RESULTS: The study included 189 patients: VH-IVUS was used to assess 253 lesions (73 stable, 82 nonculprit, and 98 culprit lesions). The thin-cap fibroatheroma phenotype (VH-TCFA) was more frequent among lesions in patients with ACS (55.1% in culprit lesions, 36.6% in nonculprit lesions and 14.4% in stable lesions; P = .007). The arc of the VH-TCFA exposed to the vessel lumen was significantly greater in culprit lesions than in nonculprit lesions (122.28° ± 58 vs 89.46° ± 52; respectively; P = .007). Multivariate analysis showed that VH-TCFA (OR 2.1; P = .033), calcified nodules (OR 2.1; P = .046), positive remodeling (OR 3.5; P < .001) and necrotic core volume (OR 1.02;P = .009) were independently associated with a clinically identified culprit lesion. CONCLUSIONS: Plaque phenotype, rather than the proportion of each tissue, appears to be associated with plaque instability. VH-TCFA, particularly subtype IV, is associated with lesions responsible for ACS.

Effects of high-resistance circuit training in an elderly population.

The aim of this study was to determine the efficacy of a program of high-resistance circuit (HRC) training, and to compare the effects of HRC to traditional heavy strength (TS) training on strength, muscle size, body composition and measures of cardiovascular fitness in a healthy elderly population. Thirty-seven healthy men and women (61.6±5.3years) were randomly assigned to HRC (n=16), TS (n=14), or a control group (CG, n=7). Training consisted of weight lifting twice a week for 12weeks. Before and after the training, isokinetic peak torque in the upper and lower body, and body composition (dual X-ray absorptiometry) were determined. In addition, cardiovascular parameters were evaluated during an incremental treadmill test. Both HRC and TS groups showed significant increases in isokinetic strength (p<0.001), and the increase was significantly greater in the experimental groups than in CG (p<0.03). There were significant increases in lean mass (HRC, p<0.001; TS, p=0.025) and bone mineral density (HRC, p=0.025; TS, p=0.018) in the experimental groups. Only HRC showed a significant decrease in fat mass (p=0.011); this decrease was significantly greater in HRC than in CG (p=0.039). There were significant improvements in walking economy in the HRC group (p<0.049), although there were no statistical differences between groups. There were no changes in any variables in CG. Hence, HRC training was as effective as TS for improving isokinetic strength, bone mineral density and lean mass. Only HRC training elicited adaptations in the cardiovascular system and a decrease in fat mass.

Right coronary artery fistula to the coronary sinus.

We report the case of a 26-year-old asymptomatic woman, who presented for consultation after the detection of a cardiac murmur in a medical routine recognition. Doppler echocardiography and the 64-row multidetector computed tomography showed the presence of a significant enlargement of the right coronary artery winding in the contour of the right ventricle and its fistulosa connection to the coronary sinus. Although the coronary fistula in our patient had a considerable size, there was no ventricular dilation, and thus we chose, according to the desire of the patient, not to intervene, and to evaluate her regularly.

Neumonía fantasma / Phantom pneumonia

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