ABSTRACT
Abstract Sarcopenia is a pathology resulting from a progressive and severe loss of muscle mass, strength, and function in the course of aging, which has deleterious consequences on quality of life. Among the most widespread studies on the issue are those focused on the effect of different types of physical exercise on patients with sarcopenia. This randomized controlled study aimed to compare the effects of a whole-body vibration exercise (WBV) session on the inflammatory parameters of non-sarcopenic (NSG, n=22) and sarcopenic elderly (SG, n=22). NSG and SG participants were randomly divided into two protocols: intervention (squat with WBV) and control (squat without WBV). After a one-week washout period, participants switched protocols, so that everyone performed both protocols. Body composition was assessed by dual-energy radiological absorptiometry (DXA) and function through the six-minute walk test (6MWD) and Short Physical Performance Battery (SPPB). Plasma soluble tumor necrosis factor receptors (sTNFR) were determined by enzyme-linked immunosorbent assay (ELISA) and measured before and immediately after each protocol. After exercise with WBV, there was an increase in sTNFR2 levels in the NSG (P<0.01; d=-0.69 (-1.30; -0.08) and SG (P<0.01, d=-0.95 (-1.57; -0.32) groups. In conclusion, an acute session of WBV influenced sTNFr2 levels, with sarcopenic individuals showing a greater effect. This suggested that WBV had a more pronounced impact on sTNFr2 in those with loss of muscle strength and/or physical performance. Additionally, WBV is gaining recognition as an efficient strategy for those with persistent health issues.
ABSTRACT
ANTECEDENTES: España ha sido uno de los países más afectados por la pandemia de COVID-19. OBJETIVO: Crear un registro de pacientes hospitalizados en España por COVID-19 para mejorar nuestro conocimiento sobre los aspectos clínicos, diagnósticos, terapéuticos y pronósticos de esta enfermedad. MÉTODOS: Estudio de cohorte retrospectiva, multicéntrico, que incluye pacientes consecutivos hospitalizados con COVID-19 confirmada en toda España. Se obtuvieron los datos epidemiológicos y clínicos, las pruebas complementarias al ingreso y a los 7 días de la admisión, los tratamientos administrados y la evolución a los 30 días de hospitalización de las historias clínicas electrónicas. RESULTADOS: Hasta el 30 de junio de 2020 se incluyeron 15.111 pacientes de 150 hospitales. Su mediana de edad fue 69,4 años (rango: 18-102 años) y el 57,2% eran hombres. Las prevalencias de hipertensión, dislipemia y diabetes mellitus fueron 50,9%, 39,7% y 19,4%, respectivamente. Los síntomas más frecuentes fueron fiebre (84,2%) y tos (73,5%). Fueron frecuentes los valores elevados de ferritina (73,5%), lactato deshidrogenasa (73,9%) y dímero D (63,8%), así como la linfopenia (52,8%). Los fármacos antivirales más utilizados fueron la hidroxicloroquina (85,6%) y el lopinavir/ritonavir (61,4%). El 33,1% desarrolló distrés respiratorio. La tasa de mortalidad global fue del 21,0%, con un marcado incremento con la edad (50-59 años: 4,7%; 60-69 años: 10,5%; 70-79 años: 26,9%; ≥80 años: 46%). CONCLUSIONES: El Registro SEMI-COVID-19 proporciona información sobre las características clínicas de los pacientes con COVID-19 hospitalizados en España. Los pacientes con COVID-19 hospitalizados en España son en su mayoría casos graves, ya que uno de cada 3 pacientes desarrolló distrés respiratorio y uno de cada 5 pacientes falleció. Nuestros datos confirman una estrecha relación entre la edad avanzada y la mortalidad
BACKGROUND: Spain has been one of the countries most affected by the COVID-19 pandemic. OBJECTIVE: To create a registry of patients with COVID-19 hospitalized in Spain, in order to improve our knowledge of the clinical, diagnostic, therapeutic, and prognostic aspects of this disease. METHODS: A multicentre retrospective cohort study, including consecutive patients hospitalized with confirmed COVID-19 throughout Spain. Epidemiological and clinical data, additional tests at admission and at seven days, treatments administered, and progress at 30 days of hospitalization were collected from electronic medical records. RESULTS: Up to June 30th 2020, 15,111 patients from 150 hospitals were included. Their median age was 69.4 years (range: 18-102 years) and 57.2% were male. Prevalences of hypertension, dyslipidemia, and diabetes mellitus were 50.9%, 39.7%, and 19.4%, respectively. The most frequent symptoms were fever (84.2%) and cough (73.5%). High values of ferritin (73.5%), lactate dehydrogenase (73.9%), and D-dimer (63.8%), as well as lymphopenia (52.8%), were frequent. The most used antiviral drugs were hydroxychloroquine (85.6%) and lopinavir/ritonavir (61.4%); 33.1% developed respiratory distress. Overall mortality rate was 21.0%, with a marked increase with age (50-59 years: 4.7%, 60-69 years: 10.5%, 70-79 years: 26.9%, ≥80 years: 46.0%). CONCLUSIONS: The SEMI-COVID-19 Network provides data on the clinical characteristics of patients with COVID-19 hospitalized in Spain. Patients with COVID-19 hospitalized in Spain are mostly severe cases, as one in three patients developed respiratory distress and one in five patients died. These findings confirm a close relationship between advanced age and mortality
Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Adult , Middle Aged , Aged , Aged, 80 and over , Coronavirus Infections/epidemiology , Severe Acute Respiratory Syndrome/epidemiology , Severe acute respiratory syndrome-related coronavirus/pathogenicity , Pneumonia/epidemiology , Spain/epidemiology , Inpatients/statistics & numerical data , Hospitalization/statistics & numerical data , Length of Stay/statistics & numerical data , Retrospective Studies , Diseases Registries/statistics & numerical dataABSTRACT
La esclerosis lateral amiotrófica es una enfermedad neurodegenerativa rara con un curso rápido y fatal. La ausencia de tratamientos efectivos ha hecho surgir nuevas líneas de investigación, entre ellas las basadas en células madre. La inyección quirúrgica intramedular, que ha sido la principal vía de administración, ha demostrado ser segura en los ensayos de seguridad del procedimiento. Sin embargo, persisten desafíos como la mejor vía de administración o el modo de comprobar la supervivencia de las células y su interacción con la diana terapéutica. La misión de las técnicas de neuroimagen ha sido hasta ahora la detección de lesiones y complicaciones espinales y medulares, pero tienen potencial para sustituir al estudio anatomopatológico, analizando la relación de las células implantadas con la diana terapéutica, y como biomarcadores de la enfermedad, midiendo cambios morfológicos y funcionales postratamiento, lo que implicará más a los radiólogos en el manejo clínico de estos enfermos
Amyotrophic lateral sclerosis is a rare neurodegenerative disease with a rapid fatal course. The absence of effective treatments has led to new lines of research, some of which are based on stem cells. Surgical injection into the spinal cord, the most common route of administration of stem cells, has proven safe in trials to test the safety of the procedure. Nevertheless, challenges remain, such as determining the best route of administration or the way of checking the survival of the cells and their interaction with the therapeutic target. To date, the mission of neuroimaging techniques has been to detect lesions and complications in the spine and spinal cord, but neuroimaging also has the potential to supplant histologic study in analyzing the relations between the implanted cells and the therapeutic target, and as biomarkers of the disease, by measuring morphological and functional changes after treatment. These developments would increase the role of radiologists in the clinical management of patients with amyotrophic lateral sclerosis
Subject(s)
Humans , Neuroimaging/methods , Stem Cell Transplantation/methods , Amyotrophic Lateral Sclerosis/diagnosis , Amyotrophic Lateral Sclerosis/therapy , Biomarkers/analysis , Treatment OutcomeABSTRACT
Cuando la probabilidad de tromboembolia pulmonar (TEP) es baja, hacer una angiografía pulmonar por tomografía computarizada (APTC) depende del valor del dímero D. Sobreutilizar esta determinación puede dar lugar a estudios de imagen innecesarios, tratar de manera inadecuada al paciente o incrementar indebidamente la probabilidad estimada para enfermedad tromboembólica venosa a partir de ese momento. El objetivo principal de este trabajo es valorar cuándo puede evitarse la APTC en pacientes con baja probabilidad clínica de TEP a partir de una búsqueda bibliográfica eficiente de los estudios publicados al respecto
When the probability of pulmonary embolism is low, the decision to do a computed tomography angiography (CTA) of the pulmonary vessels is based on the D-dimer concentration. However, excessive dependence on this parameter can result in unnecessary imaging studies, inappropriate treatment, or an inappropriate increase in the estimated probability of venous thromboembolism developing. The main objective of this study was to determine when CTA of pulmonary vessels could be avoided in patients with low clinical probability of pulmonary embolism through an efficient literature search of studies published about this question
Subject(s)
Humans , Pulmonary Embolism/diagnostic imaging , Computed Tomography Angiography , Disease Susceptibility , Risk Factors , Unnecessary Procedures , Acute DiseaseABSTRACT
Cuando la sospecha clínica es confirmada mediante una prueba diagnóstica, se puede administrar el tratamiento indicado. El problema se plantea cuando la prueba diagnóstica no confirma el diagnóstico inicial de sospecha, y más aún cuando la sospecha se fundamenta en reglas de predicción clínica validadas y es elevada. Esta situación se da hasta en el 40% de los pacientes con sospecha alta de tromboembolia pulmonar (TEP) aguda, por lo que se cuestiona si debe realizarse una angiografía por tomografía computarizada (angio-TC) de arterias pulmonares de manera sistemática. En este trabajo se ha revisado la bibliografía al respecto y se muestra la mejor evidencia sobre las recomendaciones relevantes en pacientes con alta sospecha clínica de TEP aguda y angio-TC negativa, así como los conceptos probabilísticos derivados del teorema de Bayes para tratar de discernir la actitud más apropiada
When a diagnostic test confirms clinical suspicion, the indicated treatment can be administered. A problem arises when the diagnostic test does not confirm the initially suspected diagnosis; when the suspicion is grounded in clinically validated predictive rules and is high, the problem is even worse. This situation arises in up to 40% of patients with high suspicion for acute pulmonary embolism, raising the question of whether CT angiography of the pulmonary arteries should be done systematically. This paper reviews the literature about this issue and lays out the best evidence about the relevant recommendations for patients with high clinical suspicion of acute pulmonary embolism and negative findings on CT angiography. It also explains the probabilistic concepts derived from Bayes' theorem that can be useful for ascertaining the most appropriate approach in these patients
Subject(s)
Humans , Pulmonary Embolism/diagnostic imaging , Computed Tomography Angiography , Pulmonary Artery/diagnostic imaging , Evidence-Based Medicine/methods , Early Diagnosis , Predictive Value of Tests , Multidetector Computed Tomography/methods , Prospective StudiesABSTRACT
The aims of this study were 1) to characterize the intensity of the vibration stimulation in women diagnosed with fibromyalgia (FM) compared to a control group of healthy women (HW) matched by age and anthropometric parameters, and 2) to investigate the effect of a single session of whole body vibration (WBV) on inflammatory responses. Levels of adipokines, soluble tumor necrosis factor receptors (sTNFr1, sTNFr2), and brain-derived neurotrophic factor (BDNF) were determined by enzyme-linked immunosorbent assay. Oxygen consumption (VO2) was estimated by a portable gas analysis system, heart rate (HR) was measured using a HR monitor, and perceived exertion (RPE) was evaluated using the Borg scale of perceived exertion. Acutely mild WBV increased VO2 and HR similarly in both groups. There was an interaction (disease vs vibration) in RPE (P=0.0078), showing a higher RPE in FM compared to HW at rest, which further increased in FM after acute WBV, whereas it remained unchanged in HW. In addition, there was an interaction (disease vs vibration) in plasma levels of adiponectin (P=0.0001), sTNFR1 (P=0.000001), sTNFR2 (P=0.0052), leptin (P=0.0007), resistin (P=0.0166), and BDNF (P=0.0179). In conclusion, a single acute session of mild and short WBV can improve the inflammatory status in patients with FM, reaching values close to those of matched HW at their basal status. The neuroendocrine mechanism seems to be an exercise-induced modulation towards greater adaptation to stress response in these patients.
Subject(s)
Humans , Female , Middle Aged , Vibration , Exercise , Fibromyalgia/blood , Fibromyalgia/therapy , Inflammation Mediators/blood , Oxygen Consumption/physiology , Enzyme-Linked Immunosorbent Assay , Biomarkers/blood , Case-Control Studies , Interleukin-8/blood , Receptors, Tumor Necrosis Factor/blood , Brain-Derived Neurotrophic Factor/blood , Leptin/blood , Resistin/blood , Adipokines/blood , Heart Rate/physiology , Inflammation/blood , Inflammation/therapyABSTRACT
Para establecer el poder discriminatorio entre sujetos enfermos y sanos de un biomarcador potencial es esencial conocer la variabilidad intrínseca de su método de medida. Este aspecto es especialmente importante en el caso de la medida ecográfica del grosor íntima-media carotídeo, cuyas variaciones submilimétricas, debidas en gran parte a la falta de precisión de la técnica ecográfica y no asumidas como tales, pueden tener un gran impacto clínico en la clasificación del riesgo cardiovascular. El objetivo de este trabajo es presentar la evidencia sobre la reproducibilidad de la medida del grosor del complejo íntima-media carotídeo, obtenida mediante ecografía, para discutir si la variabilidad de la técnica puede influir en el potencial de este parámetro como biomarcador (AU)
To establish the ability of a potential biomarker to discriminate between diseased and healthy subjects, it is essential to know the intrinsic variability of the methods used to measure the biomarker. This aspect is especially important in the ultrasonographic measurement of carotid intima-media thickness, where submillimetric variations due largely to the unrecognized lack of precision in the ultrasonographic technique can have a significant clinical impact on the classification of cardiovascular risk. This article aims to present the evidence about the reproducibility of carotid intima-media thickness measured by ultrasonography to discuss whether the variability inherent in the technique can influence the potential of this parameter as a biomarker (AU)
Subject(s)
Humans , Carotid Intima-Media Thickness/classification , Coronary Artery Disease/diagnostic imaging , Biomarkers/analysis , Cardiovascular Diseases/diagnostic imaging , Risk Factors , Primary Prevention/methods , Mass Screening/methods , Reproducibility of Results , Reproducibility of ResultsABSTRACT
No disponible
Subject(s)
Humans , Periodicals as Topic/standards , Periodicals as Topic/trends , Periodical , Radiology/education , Radiology/history , Radiology/standards , Societies, Medical/standardsABSTRACT
El propósito del estudio es analizar los posibles efectos de la actividad física sobre la salud autopercibida. Para ello, se encuestó a 765 personas entre 50-70 años durante 2012 en España. Se utilizó el cuestionario internacional de actividad física (IPAQ) para estimar el equivalente metabólico de la tarea (MET) total y en cuatro ámbitos: trabajo, ocio, hogar y desplazamientos. La salud auto-percibida se obtuvo de la escala visual analógica del EQ-5D-5L. Los resultados muestran que únicamente el gasto energético de actividad física en el tiempo de ocio incide positivamente en el nivel de salud percibido, el resto de ámbitos no tienen influencia significativa. Asimismo, la autopercepción de la salud es más negativa con mayor edad, menor nivel educativo y mayor frecuencia de uso de servicios sanitarios. En conclusión, la actividad física desarrollada en el tiempo libre podría plantearse como alternativa para mejorar la calidad de vida de los mayores (AU)
The purpose of the study was to analyse possible related effects between exercise and self-perceived health among people over 50 years old. A survey was conducted in 2012 to 765 community-living subjects from Spain aged between 50 and 70 years. The survey includes the long version of the International Physical Activity Questionnaire (IPAQ) to estimate total physical activity/week in METS (Measure Activity in Metabolic Equivalents) and in four different domains: work, leisure, transport and domestic/gardening. Self-perceived health was measured using the Visual Analogic Scale of the EQ-5D-5L. The results of the study show that only the level of physical activity developed in leisure time has a positive and statistically significant effect on self-perceived health, whilst the other domains of physical activity are non-significant. Additionally, age, lower educational level and a higher use of health-care services are negatively associated with self-perceived health. To sum up, leisure time physical activity could be an alternative to increase the quality of life of older people (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Motor Activity/physiology , Health Behavior , Health Services/standards , Health Status , Quality of Life , Surveys and Questionnaires , Health Services , Visual Analog Scale , TelephoneABSTRACT
No disponible
Subject(s)
Humans , Radiology/education , Radiology/methods , Radiology/statistics & numerical data , Radiology Department, Hospital , Radiology, Interventional , Students, Medical/statistics & numerical data , Education, Medical/organization & administration , Education, Medical/standardsABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Osteoarthropathy, Secondary Hypertrophic/complications , Osteoarthropathy, Secondary Hypertrophic/therapy , Osteoarthropathy, Secondary Hypertrophic , Arthralgia/complications , Arthralgia , Primary Health Care/methods , Primary Health Care/trends , Asthenia/complications , Knee/pathology , Knee , Radionuclide Imaging , Carcinoma/complications , Lung Neoplasms/complications , Bronchoscopy/methodsABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Informed Consent/ethics , Occupational Health Services/classification , Occupational Health Services/ethics , Spain , Radiation Oncology/education , Radiation Oncology/classification , Informed Consent/standards , Occupational Health Services/methods , Occupational Health Services , Radiation Oncology/instrumentation , Radiation Oncology/methods , Personal Autonomy , Hypothesis-TestingABSTRACT
No disponible
Subject(s)
Radiology/ethics , Radiology , Research/education , Research , Research Personnel/ethics , Health Personnel/ethics , Health Personnel/trendsABSTRACT
No disponible
Subject(s)
Morale , Radiology/ethics , Radiology/history , Radiology , Radiology Information Systems/ethics , Radiology Information Systems , Radiology Information Systems/standards , Radiology/legislation & jurisprudence , Radiology Information Systems/history , Radiology Information Systems/legislation & jurisprudence , Radiology Information Systems/organization & administrationABSTRACT
No disponible
Subject(s)
Humans , Radiology/ethics , Radiology/legislation & jurisprudence , Radiology , Radiology Information Systems/ethics , Copyright/ethics , Radiology/organization & administration , Radiology Information Systems/organization & administration , Radiology Information Systems/statistics & numerical data , Societies, Medical/ethics , Societies, Medical/organization & administration , Societies, Medical/standards , Editorial PoliciesABSTRACT
No disponible
Subject(s)
Humans , Female , Middle Aged , Aneurysm/diagnosis , Tomography, X-Ray Computed , Heart Murmurs/diagnosis , Constriction, PathologicABSTRACT
No disponible
Subject(s)
Humans , Female , Adult , Aneurysm/diagnosis , Heart Murmurs/diagnosis , Tomography, X-Ray Computed , Diagnostic ImagingABSTRACT
No disponible
