A field tool for the aerobic power evaluation of middle-aged female recreational runners.

This study used time to exhaustion (TTE) to predict V̇O2max in female recreational master runners. Forty-two middle-aged women (mean = 40.5 ± 5.9 years) who had trained for recreational running performed two Université de Montréal Track Tests in the facilities of the University of Barcelona (Spain). The first was performed on a treadmill (t), the second, on an athletics track (field: f). After measuring TTE and V̇O2max on the treadmill, a first-order equation was obtained to estimate fV̇O2max from fTTE. No significant difference was observed between the estimated fV̇O2max (46.5 ± 2.9 mL·kg-1·min-1) and the measured tV̇O2max (46.2 ± 5.3), with a mean value of the absolute differences of less than 8% of the tV̇O2max average. High agreement between the two V̇O2max values was also evident, as shown by the low bias of the differences and the Bland-Altman plot. The equation obtained is of interest to evaluate performance in middle-aged female recreational runners. It will allow coaches and runners to set running paces for training and could be used in training routines to determine improvements after a training program. Moreover, these tools could be used in the field to assess the physical fitness of middle-aged women, in efforts to preserve their health and physical function.

Changes in dietary intake, plasma carotenoids and erythrocyte membrane fatty acids in breast cancer survivors after a lifestyle intervention: results from a single-arm trial.

BACKGROUND: The influence of nutrition on breast cancer prognosis is still inconclusive and therefore dietary interventions incorporating dietary biomarkers are needed to confirm compliance with dietary goals and clarify biological mechanisms. The present study assessed whether a lifestyle intervention in breast cancer survivors could affect dietary biomarkers of fruit and vegetables and fatty acids. METHODS: In this phase II single-arm trial, 37 overweight/obese early stage breast cancer patients completed a 12-week diet and exercise intervention. The intervention involved 1-h weekly diet sessions delivered by a dietician and 75-min bi-weekly physical activity sessions of moderate-to-high intensity led by trained monitors. Before and after the intervention, three 24-h dietary recalls were carried out to calculate nutrient intakes and, in addition, blood samples were taken to measure plasma carotenoids, vitamin E and retinol concentrations and erythrocyte membrane fatty acid (EFA) composition. Wilcoxon signed rank tests were used to assess changes in dietary and biomarkers measurements over the intervention period. RESULTS: After the intervention, there was a significant increase in the intake of dietary carotenoids (+15.1% compared to baseline) but not plasma carotenoids levels (+6.3%). Regarding the EFA levels, we observed a significant decrease in percentage of saturated fatty acids (-1.4%) and n-6 polyunsaturated fatty acids (-2.9%) and an increase in monounsaturated fatty acids (1.7%) and total and long-chain n-3 polyunsaturated fatty acids (by 13.1% and 13.7%, respectively). A favourable decrease in the ratio of long-chain n-6 to n-3 polyunsaturated fatty acids (-9.1%) was also observed. CONCLUSIONS: After a short-term diet and exercise intervention in overweight/obese breast cancer survivors, we observed significant changes in dietary nutrients and fatty acid biomarkers, suggesting positive dietary changes that could be relevant for breast cancer prognosis.

Sildenafil does not Improve Exercise Capacity under Acute Hypoxia Exposure.

The increase in pulmonary arterial pressure (PAP) due to hypoxic pulmonary vasoconstriction (HPV) could be a limiting factor for physical performance during hypoxic exposure. Sildenafil has been shown to reduce PAP in situations of moderate or severe hypoxia, and consequently its role as an ergogenic aid and even a possible doping substance must be considered. We performed a double-blind crossover study to determine the effects of sildenafil on cardiovascular, respiratory and metabolic parameters in normoxia and during acute exposure to hypobaric hypoxia (4 000 m) at rest and during maximal and submaximal (60% VO2 max) exercise tests. One hour before testing started, sildenafil (100 mg) or a placebo was orally administered to 11 volunteers. In normoxic conditions, sildenafil did not affect performance. Similarly, no significant differences were found in cardiovascular and respiratory parameters in hypoxic conditions at rest or during exercise. The use of sildenafil to improve physical performance in non-acclimatized subjects is not supported by our data.

5-year mortality in cardiac surgery patients with low cardiac output syndrome treated with levosimendan: prognostic evaluation of nt-probnp and c-reactive protein.

AIM: To determine the clinical risk factors predictive of the 5--year mortality in patients with low cardiac output syndrome (LCOS) after cardiac surgery. In addition, to assess the influence of inflammation and myocardial dysfunction severity, as measured by C--reactive protein (CRP) and N--terminal pro--brain natriuretic peptide (NT--proBNP) concentrations, on outcome. METHODS: We studied 30 patients who underwent cardiac surgery and developed postoperative LCOS requiring inotropic support for longer than 48 hours after intensive care unit (ICU) admission. All patients received a 24--hour infusion of levosimendan after study enrolment. We measured the following at baseline, 24 h, 48 h and 7 days: clinical data, serum NT--proBNP and serum CRP levels. Patients were followed--up at 5 years for death by any cause. A risk--adjusted Cox proportional hazards regression model was used for statistical analysis. Hazard ratios and their 95% confidence intervals (CI) are presented. RESULTS: The 5--year mortality was 36.6% (n = 11). The predictors of 5--year mortality were the presence of dilated cardiomyopathy (HR = 36.909; 95% CI: 1.901-716.747; P = 0.017), a higher central venous pressure (CVP) at 48 hours (HR = 2.686; 95% CI: 1.383-5.214; P = 0.004), and lower CRP levels on day 7 (HR = 0.963; 95% CI: 0.933-0.994; P = 0.021). NT--proBNP levels showed a trend to higher initial levels in survivors without statistical significance, but were not associated with 5--year mortality. CONCLUSIONS: The presence of dilated cardiomyopathy, elevated CVP at 48 h and reduced CRP levels on day 7 predicted 5--year mortality in patients who developed postoperative LCOS after cardiac surgery. NT--proBNP levels in the first postoperative week were not predictors of long--term outcomes.

CD34+ circulating progenitor cells after different training programs.

Circulating progenitor cells (CPC) are bone marrow-derived cells that are mobilized into the circulation. While exercise is a powerful mediator of hematopoiesis, CPC levels increase, and reports of their activation after different types of exercise are contradictory. Moreover, few studies have compared the possible effects of different training programs on CPC concentrations. 43 physically active healthy male subjects (age 22±2.4 years) were assigned to 4 different training groups: aerobic, resistance, mixed and control. Except for the control group, all participants trained for 6 weeks. Peripheral blood samples were collected through an antecubital vein, and CPC CD34(+) was analyzed on different days: pre-training, post-training, and 3 weeks after finishing the training period. While no significant differences in CPC were observed either within or between the different training groups, there was a tendency towards higher values post-training and large intra- and intergroup dispersion. We detected an inverse linear relationship between pre-training values and % of CPC changes post-training (p<0.001). In the CPC values 3 weeks after training this inverse relationship was maintained, though to a lower extent (p<0.001). No changes in CPC CD34(+) were detected after 6 weeks of different training groups, or after 3 weeks of follow-up.

Predictors of long-term mortality in patients with cirrhosis undergoing cardiac surgery.

AIM: Little is known regarding the long-term outcome in cirrhotic patients undergoing cardiac surgery. The objective of this study was to identify preoperative and postoperative mortality risk factors and to determine the best predictors of long-term outcome. METHODS: Fifty-eight consecutive cirrhotic patients requiring cardiac surgery between January 2004 and January 2009 were prospectively studied at our institution. Seven patients (12%) died. A complete follow-up was performed in the whole survival group until November 2012 (mean 46±28 months). Variables usually measured on admission and during the first 24 h of the postoperative period were evaluated together with cardiac surgery scores (Parsonnet, EuroSCORE), liver scores (Child-Turcotte-Pugh, Model for End-Stage Liver Disease, United Kingdom End-Stage Liver Disease score), and ICU scores (Acute Physiology and Chronic Health Evaluation II and III, Simplified Acute Physiology Score II and III, Sequential Organ Failure Assessment). RESULTS: Twelve patients (23.5%) died during follow-up; six were Child class A and six class B. Comparing survivors vs. non-survivors using univariate analysis, variables associated with better long-term outcome were lower arterial lactate 24 h after admission (1.7±0.4 vs. 2.1±0.7 mmol·L(-1), P=0.03) and higher urine output in the first 24 h (2029±512 vs. 1575±627 mL, P=0.03). The receiver operating characteristic curve showed that the Simplified Acute Physiology Score III score had the best predictive value for long-term outcome (AUC: 77.4±0.76%; sensitivity: 83.3%; specificity: 64.9%, P=0.005). Multivariate analysis identified Simplified Acute Physiology Score III score (P=0.02) and urine output in the first 24 h (P=0.02) as independent factors associated with long-term outcome. Long-term survival was 82.4% for Child A, 47.6% for Child B and 33.3% for Child C (P=0.001). CONCLUSION: Long-term survival in cirrhotic patients requiring cardiac surgery is a more valuable prognostic measure than short-term survival. Urine output in the first 24 h may be a valuable predictor of long-term outcome in these patients. The Simplified Acute Physiology Score III is also useful.

Effect of a diet and physical activity intervention on body weight and nutritional patterns in overweight and obese breast cancer survivors.

Energy restriction from a low-calorie diet and increased energy expenditure induced by physical activity (PA) could promote weight loss/maintenance and be important determinants of breast cancer (BC) prognosis. The aim of this study was to assess participation and adherence of overweight and obese BC survivors to a lifestyle intervention and to demonstrate the capacity of this intervention to induce weight loss and nutritional changes. This single-arm pre-post study, which involved one-hourly weekly diet sessions delivered by a dietician and 75-min bi-weekly PA sessions of moderate-to-high intensity led by PA monitors, was offered to overweight and obese BC survivors shortly after treatment. Before and after the intervention, anthropometry, dietary information, quality of life (QoL) and cardiorespiratory fitness (CRF) were collected. A total of 112 BC survivors were invited to participate: 42 of them started the intervention and 37 completed it. Participants attended more than 90 % of the sessions offered and showed a significant weight loss of 5.6 ± 2.0 kg, as well as significant decreases in body mass index, fat mass and waist circumference. Significant decreases in total energy (-25 %), fat (-35 %), saturated fat (-37 %) and carbohydrate (-21 %) intakes were observed while QoL and CRF showed significant increases. This feasibility study demonstrated the success of a short-term diet and PA intervention to induce weight loss and promote healthful changes in BC survivors. Assessing the long-term effects of these changes, and in particular their possible impact of BC prognosis, and designing interventions reaching a wider number of BC survivors are still issues to be addressed.

Adaptación a la altura y a ambientes fríos en personas con lesión medular / Adaptation to high altitude and a cold environment in people with spinal cord injury

Objetivo: Estudiar las diferencias en la adaptación respiratoria al ejercicio en condiciones medioambientales similares a las de la práctica de los deportes de invierno, entre personas físicamente activas y sanas con lesión medular y sin lesión medular. Material y método: Participaron 24 voluntarios sanos y físicamente activos, 12 presentaban en su historia una lesión medular y los otros 12 no. Cada sujeto realizó tres pruebas de esfuerzo máximas con monitorización ventilatoria, pero modificando las circunstancias ambientales: a nivel del mar y a 22 - 24º C; a 3.000 metros e altura simulada y a 22 - 24º C, y a 3.000 metros de altura simulada y a 5 - 6º C. Resultados: Al comparar los valores observados en las pruebas de altura simulada respecto a la realizada a nivel del mar, se observó un aumento significativo de los valores del consumo de VO2 y de la producción del VCO2. Este aumento no se acompañó de modificaciones en la ventilación, la frecuencia respiratoria o el volumen corriente. Paralelamente, la fracción espirada para el O2 y el CO2, el equivalente respiratorio para el O2 y el CO2 o la presión al final de la espiración para el O2 y el CO2 mostraron cambios estadísticamente significativos. Conclusiones: La realización de un esfuerzo intenso produce importantes cambios ventilatorios con necesidades de oxígeno superiores para una altura simulada de 3.000 metros que no cambian sustancialmente con el frío (AU)

Objective: To study the differences in respiratory responses to exercise in environmental conditions similar to the practice of winter sports among physically active and healthy men with and without spinal cord injury (SCI). Methods: 24 healthy, physically active volunteers, 12 with SCI and the other 12 without SCI. Each subject performed three maximal exercise tests monitoring ventilatory parameters, but changing environmental circumstances: at sea level and 22 - 24 º C, at 3,000 meters simulated high and 22 - 24 º C, and at simulated 3,000 meters and 5 - 6 ° C. Results: When comparing the values observed in simulated altitude tests regarding the level sea, there was a significant increase of the values of oxygen uptake and VCO2 production. This increase was not accompanied by changes in ventilation, respiratory rate or tidal volume. In parallel, fractional exhaled O2 and CO2, the respiratory equivalent for O2 and CO2 and end-tidal O2 and end-tidal CO2 showed statistically significant changes. Conclusions: In a simulated altitude of 3,000 meters, an intensive effort produce significant changes with higher oxygen demand that do not vary substantially with the cold (AU)

Nicotinamida adenina dinucleótido (NADH) en pacientes con síndrome de fatiga crónica / Nicotinamide adenine dinucleotide (NADH) in patients with chronic fatigue syndrome

AntecedentesLa nicotinamida adenina dinucleótido (NADH) podría estar deplecionada en el síndrome de fatiga crónica. El objetivo del estudio fue evaluar la eficacia de la suplementación con NADH en estos pacientes.Material y métodosSe realizó un ensayo clínico, doble ciego, controlado con placebo de 3 meses de duración. Los pacientes fueron randomizados a NADH oral 20mg o placebo durante los 2 primeros meses. Se evaluó la intensidad de la fatiga, estado funcional, estado de ánimo, impacto funcional de la fatiga, calidad de vida, calidad del sueño, capacidad al ejercicio y reserva funcional, así como la opinión del investigador y pacientes sobre la eficacia de la intervención, antes y a los 30, 60 y 90 días del inicio del tratamiento. En la visita basal y a los 60 días (último día de tratamiento doble ciego) se realizó una prueba de esfuerzo.ResultadosSe incluyeron 86 enfermos de los cuales 77 concluyeron el estudio (edad media, 47 años; 72 mujeres). No se hallaron diferencias significativas en la mayoría de las variables estudiadas al finalizar el estudio. La administración de NADH se asoció a una disminución de estado de ansiedad de −1,0 puntos (p<0,05) y de −0,2 puntos (p=NS) en el grupo asignado a placebo. La frecuencia cardiaca máxima tras la prueba de esfuerzo disminuyó una media de −8,1l/min (p<0,05) en el grupo NADH y ascendió +1,7l/min en el grupo placebo (p=0,73). No se hallaron diferencias en la percepción de eficacia con NADH y placebo, por parte del investigador y pacientes.ConclusionesLa administración de NADH oral se asoció a una disminución de la ansiedad y de la frecuencia cardiaca máxima, tras una prueba de esfuerzo, en los pacientes con síndrome de fatiga crónica. Por el contrario, este tratamiento no modificó otras variables clínicas y el estado funcional global(AU)

BackgroundNicotinamide adenine dinucleotide (NADH) may be depleted in chronic fatigue syndrome (SFC). The purpose of the study was to evaluate the efficacy of supplementation with NADH in these patients.ResultsA total of 86 patients, 77 of whom completed the study (mean age, 47 years, 72 women) were enrolled. No significant differences were found in most of the variable studied at the end of the study. Administration of NADH was associated to a decrease in anxiety condition of −1.0 points (p<0.05) and of −0.2 points (p=NS) in the placebo assigned group. Maximum heart rate after the stress test decreased a mean of −8.1l/min (p<0.05) in the NADH group and increased by +1.7l/min in the placebo group (p=0.73). No differences were found in the perception of efficacy with NADH and placebo, by the investigator and patients.ConclusionsAdministration of oral NADH was associated to a decrease in anxiety and maximum heart rate, after a stress test in patients with CFS. On the contrary, this treatment did not modify other clinical variables and the global functional performance(AU)

[Nicotinamide adenine dinucleotide (NADH) in patients with chronic fatigue syndrome]. / Nicotinamida adenina dinucleótido (NADH) en pacientes con síndrome de fatiga crónica.

BACKGROUND: Nicotinamide adenine dinucleotide (NADH) may be depleted in chronic fatigue syndrome (SFC). The purpose of the study was to evaluate the efficacy of supplementation with NADH in these patients. MATERIAL AND METHODS: A double blind, placebo controlled, 3 month long clinical trial was conducted. The patients were randomized to oral NADH oral 20mg or placebo during the first two months. The intensity of the fatigue, functional performance, mood state, functional impact of the fatigue, quality of life, sleep quality, exercise capacity and functional reserve as well as the investigator's and patient's opinion on the efficacy of the intervention prior to and at 30, 60 and 90 days of the onset of the treatment were evaluated. A stress test was performed in the baseline visit and at 60 days (last day of the double blind treatment). RESULTS: A total of 86 patients, 77 of whom completed the study (mean age, 47 years, 72 women) were enrolled. No significant differences were found in most of the variable studied at the end of the study. Administration of NADH was associated to a decrease in anxiety condition of -1.0 points (p<0.05) and of -0.2 points (p=NS) in the placebo assigned group. Maximum heart rate after the stress test decreased a mean of -8.1l/min (p<0.05) in the NADH group and increased by +1.7l/min in the placebo group (p=0.73). No differences were found in the perception of efficacy with NADH and placebo, by the investigator and patients. CONCLUSIONS: Administration of oral NADH was associated to a decrease in anxiety and maximum heart rate, after a stress test in patients with CFS. On the contrary, this treatment did not modify other clinical variables and the global functional performance.