Entrenamiento resistido hipóxico y beneficio en la salud de los adultos mayores / Hypoxic resistance training and health benefits in older adults

RESUMEN Durante el envejecimiento, los factores genéticos y ambientales conllevan un mayor riesgo de enfermedades que facilitan la pérdida de la funcionalidad. El entrenamiento de resistencia de alta intensidad ha demostrado conducir a beneficios para la salud en los adultos mayores, sin embargo, su utilización es limitada en esta población. Recientemente, el entrenamiento de resistencia en hipoxia (ERH) se ha presentado como una alternativa viable en la terapia de rehabilitación para adultos mayores, con todo, la información es escasa al respecto. De esta forma, el objetivo de este estudio fue recopilar el conocimiento actual sobre el ERH en adultos mayores, así como los beneficios para su salud. Para ello, se realizó una búsqueda selectiva de artículos publicados en los últimos 6 años sobre los efectos del ERH en personas mayores en la base de datos Pubmed. La búsqueda resultó en 227 artículos, de los cuales 18 fueron seleccionados para esta revisión. Se identificaron 3 tipos de entrenamiento: terapia de restricción del flujo sanguíneo (TRFS), entrenamiento de resistencia en hipoxia hipobárica (ERHH) y entrenamiento de resistencia en hipoxia normobárica (ERHN). A partir de la información recabada, podemos indicar que el TRFS ofrece mayores efectos positivos sobre la ganancia de fuerza y la hipertrofia muscular, mientras que existe poca evidencia del ERHH y ERHN en personas mayores. Finalmente, manifestamos la necesidad de más estudios que evalúen la seguridad de esta intervención en la salud en este grupo etario.

ABSTRACT During aging, genetic and environmental factors carry an increased risk of diseases that facilitate the loss of function. High-intensity resistance training has been shown to lead to health benefits in older adults, however, its use is limited in this population. Recently, hypoxic resistance training (HRT) has been presented as a viable alternative in rehabilitation therapy for older adults, however, information is scarce in this regard. Thus, the objective of this study was to collect current knowledge about HRT in older adults, as well as the benefits for their health. To do this, a selective search was carried out for articles published in the last 6 years on the effects of HRT in older people in the Pubmed database. The search resulted in 227 articles, of which 18 were selected for this review. Three types of training were identified: blood flow restriction therapy (BFRT), resistance training in hypobaric hypoxia (RTHH), and resistance training in normobaric hypoxia (RTNH). From the information collected, we can indicate that TRFS offers greater positive effects on strength gain and muscle hypertrophy, while there is little evidence of RTHH and RTNH in older people. Finally, we express the need for more studies to evaluate the safety of this intervention in health in this age group.

Reliability and factorial validity of a questionnaire to assess organophosphate pesticide exposure to agricultural workers in Maule, Chile.

The aim was to evaluate the reliability and validity of a questionnaire to assess organophosphate pesticide (OP) exposure in agricultural workers. We then enrolled a random sample of 114 agricultural workers from the region of Maule, Chile (mean age = 50 years [SD = 12]). An internal consistency analysis (Cronbach's alpha> 0.70) and a Varimax rotational factorial analysis were applied. The instrument had a high reliability to predict likely occupational pesticide exposures: Cronbach's alpha = 0.95, the Kaiser-Meyer-Olkin (KMO) measure was 0.90 and the Bartell sphericity test = p < 0.001. Four factors explaining 68% of the variance were extracted. The factors identified were as follows: (1) labor conditions during application of OPs; (2) use of personal protective equipment; (3) workplace conditions related to OP exposure and (4) home conditions related to OP exposure. The questionnaire has adequate metric properties to characterize likely OP exposure of agricultural workers and to explore associated working and home conditions.

Exposure to organophosphate (OP) pesticides and health conditions in agricultural and non-agricultural workers from Maule, Chile.

The objective was to evaluate the characteristics of exposure to OP pesticides and health status in Chilean farm workers from the Maule Region. An occupational health questionnaire was administered in 207 agricultural and non-agricultural workers. For the group of agricultural workers, we asked about specific occupational exposure history and symptoms of OP pesticide poisoning. The main health problem of the exposed group was previous OP pesticide poisoning (p < 0.001). Fifty-six percent of agricultural workers reported symptoms consistent with acute OP pesticide poisoning. The use of respiratory personal protective equipment and younger age were protective against these symptoms, and number of years of OP pesticide exposure was positively associated with reporting symptoms of poisoning. Of the pesticide applicators 47 % reported using chlorpyrifos. The regulations regarding use and application of pesticides should be strengthened, as should training and intervention with workers to improve the use of personal protective equipment.

Plaguicidas organofosforados y efecto neuropsicológico y motor en la Región del Maule, Chile / Organophosphate pesticides and neuropsychological and motor effects in the Maule Region, Chile

Objetivo: Evaluar la exposición a plaguicidas organofosforados y el desempeño neuropsicológico y motor de trabajadores/as agrícolas y no agrícolas de la Región del Maule, Chile. Método: Estudio transversal analítico con 93 trabajadores/as agrícolas expuestos/as a plaguicidas organofosforados y 84 trabajadores/as no agrícolas no expuestos/as. Se administró una batería de cuatro pruebas neuropsicológicas junto con un examen físico neuromotor. Resultados: Los/las trabajadores/as agrícolas expuestos/as tuvieron un menor desempeño en la escala de inteligencia de Wechsler para Adultos (WAIS-IV) en comprensión verbal (Beta=−3,2; p=0,034), en velocidad de procesamiento (Beta=−4,4; p=0,036) y en la escala total (Beta=−4; p=0,016); sensibilidad discriminativa (Beta=1, p=0,009) ajustada por años de educación o edad en comparación con los controles. Conclusiones: Se sugiere el desarrollo de políticas en materia de control, venta y uso de plaguicidas organofosforados, y de intervenciones con la población expuesta respecto a medidas de seguridad (AU)

Objective: To evaluate organophosphate pesticide exposure and neuropsychological and motor performance in agricultural and non-agricultural workers in the Maule Region in Chile. Method: Analytic cross-sectional study in 93 exposed farm workers and 84 unexposed non-agricultural workers. A battery of four neuropsychological tests was administered together with a neuro-motor physical examination. Results: On the Weschler adult intelligence scale (WAIS-IV), exposed agricultural workers exhibited poorer performance than non-agricultural workers in verbal comprehension (Beta=−3.2; p=0.034) and processing speed (Beta=−4.4; p=0.036) and in the full scale (Beta=−4; p=0.016), as well as in discrimination sensitivity (Beta=1, p=0,009), adjusted by years of schooling and/or age. Conclusions: We suggest the development of policies and regulations for the control, sale and use of organophosphate pesticides and intervention strategies on safety measures aimed at the exposed population (AU)

Chronic exposure to organophosphate (OP) pesticides and neuropsychological functioning in farm workers: a review.

BACKGROUND: Previous studies have demonstrated that acute poisoning from exposure to organophosphate (OP) pesticides in agricultural workers causes adverse health effects. However, neuropsychological and cognitive effects of chronic occupational exposure to OP pesticides remain controversial. OBJECTIVE: To identify, evaluate, and systematize existing evidence regarding chronic exposure to OP pesticides and neuropsychological effects in farmworkers. METHODS: Using the PubMed search engine, a systematic review process was implemented and replicated according to the PRISMA statement. Eligibility criteria included workers over 18 years of age exposed to OP pesticides as well as assessment of neuropsychological and cognitive functioning. Search terms were in English and Spanish languages and included organophosphate and workers. RESULTS: Of the search results, 33 of 1,256 articles meet eligibility criteria. Twenty-four studies found an association between chronic occupational exposure to OP pesticides and low neuropsychological performance in workers. We classified nine of the studies to have study design limitations. Studies indicated occupational exposure to OP pesticides is linked to difficulties in executive functions, psychomotor speed, verbal, memory, attention, processing speed, visual-spatial functioning, and coordination. Nine studies find no relationship between OP pesticides exposure and neuropsychological performance. CONCLUSIONS: Overall, evidence suggests an association between chronic occupational exposure to OP pesticides and neuropsychological effects. However, there is no consensus about the specific cognitive skills affected.

[Organophosphate pesticides and neuropsychological and motor effects in the Maule Region, Chile]. / Plaguicidas organofosforados y efecto neuropsicológico y motor en la Región del Maule, Chile.

OBJECTIVE: To evaluate organophosphate pesticide exposure and neuropsychological and motor performance in agricultural and non-agricultural workers in the Maule Region in Chile. METHOD: Analytic cross-sectional study in 93 exposed farm workers and 84 unexposed non-agricultural workers. A battery of four neuropsychological tests was administered together with a neuro-motor physical examination. RESULTS: On the Weschler adult intelligence scale (WAIS-IV), exposed agricultural workers exhibited poorer performance than non-agricultural workers in verbal comprehension (ß=-3.2; p=0.034) and processing speed (ß=-4.4; p=0.036) and in the full scale (ß=-4; p=0.016), as well as in discrimination sensitivity (ß=1, p=0,009), adjusted by years of schooling and/or age. CONCLUSIONS: We suggest the development of policies and regulations for the control, sale and use of organophosphate pesticides and intervention strategies on safety measures aimed at the exposed population.

Neurodevelopmental effects in children associated with exposure to organophosphate pesticides: a systematic review.

Many studies have investigated the neurodevelopmental effects of prenatal and early childhood exposures to organophosphate (OP) pesticides among children, but they have not been collectively evaluated. The aim of the present article is to synthesize reported evidence over the last decade on OP exposure and neurodevelopmental effects in children. The Data Sources were PubMed, Web of Science, EBSCO, SciVerse Scopus, SpringerLink, SciELO and DOAJ. The eligibility criteria considered were studies assessing exposure to OP pesticides and neurodevelopmental effects in children from birth to 18 years of age, published between 2002 and 2012 in English or Spanish. Twenty-seven articles met the eligibility criteria. Studies were rated for evidential consideration as high, intermediate, or low based upon the study design, number of participants, exposure measurement, and neurodevelopmental measures. All but one of the 27 studies evaluated showed some negative effects of pesticides on neurobehavioral development. A positive dose-response relationship between OP exposure and neurodevelopmental outcomes was found in all but one of the 12 studies that assessed dose-response. In the ten longitudinal studies that assessed prenatal exposure to OPs, cognitive deficits (related to working memory) were found in children at age 7 years, behavioral deficits (related to attention) seen mainly in toddlers, and motor deficits (abnormal reflexes) seen mainly in neonates. No meta-analysis was possible due to different measurements of exposure assessment and outcomes. Eleven studies (all longitudinal) were rated high, 14 studies were rated intermediate, and two studies were rated low. Evidence of neurological deficits associated with exposure to OP pesticides in children is growing. The studies reviewed collectively support the hypothesis that exposure to OP pesticides induces neurotoxic effects. Further research is needed to understand effects associated with exposure in critical windows of development.

Predictors of exposure to organophosphate pesticides in schoolchildren in the Province of Talca, Chile.

BACKGROUND: Few data exist in Latin America concerning the association between organophosphate (OP) urinary metabolites and the consumption of fruits and vegetables and other exposure risk variables in schoolchildren. METHODS: We collected samples of urine from 190 Chilean children aged 6-12 years, fruits and vegetables, water and soil from schools and homes, and sociodemographic data through a questionnaire. We measured urinary dialkylphosphate (DAP) OP metabolites and OP pesticide residues in food consumed by these 190 children during two seasons: December 2010 (summer) and May 2011 (fall). We analyzed the relationship between urinary DAP concentrations and pesticide residues in food, home pesticide use, and residential location. RESULTS: Diethylalkylphosphates (DEAP) and dimethylalkylphosphates (DMAP) were detected in urine in 76% and 27% of the samples, respectively. Factors associated with urinary DEAP included chlorpyrifos in consumed fruits (p<0.0001), urinary creatinine (p<0.0001), rural residence (p=0.02) and age less than 9 years (p=0.004). Factors associated with urinary DMAP included the presence of phosmet residues in fruits (p<0.0001), close proximity to a farm (p=0.002), home fenitrothion use (p=0.009), and season (p<0.0001). CONCLUSIONS: Urinary DAP levels in Chilean school children were high compared to previously reported studies. The presence of chlorpyrifos and phosmet residues in fruits was the major factor predicting urinary DAP metabolite concentrations in children.