Effects of a 30-week combined training program in normoxia and in hypoxia on exercise performance and health-related parameters in obese adolescents: a pilot study.

BACKGROUND: A light but regular combined training program is sufficient to improve health in obese adolescents. Hypoxia is known to potentiate the effects of a high intensity period of combined training on exercise performance and glucose metabolism in this population. Here, we tested the effects of a less intensive hypoxic combined training program on exercise performance and health-related markers in obese adolescents. METHODS: Fourteen adolescents volunteered to participate to a 30-week combined training protocol whether in normoxia (FiO2 21%, NE, N.=7) or in hypoxia (FiO2 15%, HE, N.=7). Once a week, adolescents exercised for 50-60min including 12min on a cycloergometer and strength training of the abdominal, quadriceps and biceps muscles. RESULTS: Combined training reduced body mass (NE: -12%; HE: -8%), mainly due to a loss in fat mass (NE: -26%; HE: -15%), similarly in both the hypoxic and normoxic groups. After training, maximal O2 consumption (VO2max) (NE: +30%; HE: +25%,), maximal aerobic power (MAP) (NE: +20%; HE: +36%), work capacity and one-repetition maximum (1RM) for the quadriceps (NE: +26%; HE: +12%), abdominal (NE: +48%; HE: +36%) and biceps muscles (NE: +26%; HE: +16%) were increased similarly in both groups but insulin sensitivity markers were not modified. CONCLUSIONS: Except for insulin sensitivity, 1h a week of combined training for 30 weeks improved morphological and health-related markers as well as exercise performance in obese adolescents in both normoxic and hypoxic conditions. This is of particular importance for motivating those adolescents, who often are reluctant to exercise. Even a low dose of exercise per week can induce positive health outcomes.

Diabetes and Prediabetes Classification Using Glycemic Variability Indices From Continuous Glucose Monitoring Data.

BACKGROUND: Tens of glycemic variability (GV) indices are available in the literature to characterize the dynamic properties of glucose concentration profiles from continuous glucose monitoring (CGM) sensors. However, how to exploit the plethora of GV indices for classifying subjects is still controversial. For instance, the basic problem of using GV indices to automatically determine if the subject is healthy rather than affected by impaired glucose tolerance (IGT) or type 2 diabetes (T2D), is still unaddressed. Here, we analyzed the feasibility of using CGM-based GV indices to distinguish healthy from IGT&T2D and IGT from T2D subjects by means of a machine-learning approach. METHODS: The data set consists of 102 subjects belonging to three different classes: 34 healthy, 39 IGT, and 29 T2D subjects. Each subject was monitored for a few days by a CGM sensor that produced a glucose profile from which we extracted 25 GV indices. We used a two-step binary logistic regression model to classify subjects. The first step distinguishes healthy subjects from IGT&T2D, the second step classifies subjects into either IGT or T2D. RESULTS: Healthy subjects are distinguished from subjects with diabetes (IGT&T2D) with 91.4% accuracy. Subjects are further subdivided into IGT or T2D classes with 79.5% accuracy. Globally, the classification into the three classes shows 86.6% accuracy. CONCLUSIONS: Even with a basic classification strategy, CGM-based GV indices show good accuracy in classifying healthy and subjects with diabetes. The classification into IGT or T2D seems, not surprisingly, more critical, but results encourage further investigation of the present research.

Choque cardiogénico en el infarto agudo del miocardio: tratamiento con angioplastía coronaria / Coronary angioplasty for cardiogenic shock in acute myocardial infarction

La disfunción ventricular es la causa más frecuente de mortalidad intrahospitalaria en pacientes con infarto agudo del miocardio complicado con un choque cardiogénico. Cuando se hace manifiesto el choque cardiogénico, la mortalidad resulta aún muy alta. Se trataron 7 pacientes, con choque cardiogénico en la etapa aguda de un infarto, con angioplastía coronaria de emergencia. Cuatro pacientes requirieron reanimación cardiopulmonar (RCP), dos necesitaron soporte con balón de contrapulsación intraaórtico y uno, apoyo hemodinámico con bomba de circulación extracorpórea fémoro-femor durante la angioplastía coronaria. La tasa de éxito angiográfico fue del 86 por ciento. Dos pacientes murieronÑ uno en la sala de hemodinámica y otro 24 horas más tarde. La mortalidad intrahospitalaria fue de 29 por ciento. De los pacientes que sobrevivieron, 4 están en clase funcional I y otro está en clase funcional II(NTHA). El tratamiento con angioplastía coronaria en pacientes con choque cardiogénico complicado al infarto agudo del miocardio, juega un papel decisivo en la reducción de la mortalidad