The referral centers for the diagnosis and treatment of hypertension in adolescents

Primary hypertension in adolescence was felt to be quite rare. However, the worldwide childhood obesity epidemic has had a profound impact on the frequency of high blood pressure (BP) with the result that primary hypertension should now be viewed as one of the most common health conditions in the young (estimated prevalence 1–5%). Therefore, current guidelines recommend that all children and adolescents seen in a medical setting should have their BP measured. The availability of BP tables with normal BP percentiles for age, sex and height has improved BP values classification. Studies conducted at referral clinics for evaluation of hypertension have indicated that as many as 30 to 40% of adolescents may actually have in a clinical setting white-coat hypertension. This may lead to a misdiagnosis of “true” hypertension in a considerable number of cases. The usefulness of out-of-office BP evaluation using ambulatory or home monitoring is well established. These measurements allow the detection of the white-coat and masked hypertension, the opposite of white-coat hypertension, and are more closely associated with organ damage and cardiovascular risk than office measurements. A thorough familial and personal history is of primary importance as well as the physical examination that should be focused on the search for signs suggestive for an underlying cause and/or for the severity of hypertension. Following investigations must be tailored to the child’s age, anamnesis and clinical examination and to the severity of BP elevation, in order to investigate not only the possible cause of hypertension, but also associated diseases and target organs damage. Therapeutic approach should firstly include non-pharmacological measures, and the use of medications when indicated. A key role in the management of the adolescents with hypertension may be attributed to the hypertension referral center

Lessons From COVID-19: Physical Exercise Can Improve and Optimize Health Status

The outbreak of Coronavirus Disease 2019 (COVID-19) has caused increasing challenges for healthcare systems globally. The disease spread rapidly from Wuhan to the rest of the world, involving more than 400 million individuals and including more than 5 million deaths. In dealing with the pandemic, China and other countries took protective measures such as promoting social distancing, canceling public gatherings, closing schools, quarantining, and imposing lockdowns. All these measures lead to physical inactivity. Being physically inactive has significant repercussions on the status of physical and mental wellbeing, and it is associated with anxiety, stress, increased chronic disease risk, and worsening of chronic conditions. In this sense, the relevance of maintaining a healthy lifestyle through physical exercise has been outlined by the World Health Organization (WHO). The aim of this mini review is to discuss the importance of physical activity in the context of the COVID-19 pandemic, highlighting the benefits of physical activity and exercise that could be potentially effective treatment strategies for comorbid chronic conditions, long covid syndrome (LCS), and symptoms such as depression and anxiety

A low resting metabolic rate is associated with metabolic syndrome

Background & aims: The metabolic syndrome is associated with central accumulation of fat. Previous studies showed that some obese subjects are characterized by a sparing energy metabolism. The aim of this study was to investigate whether obese subjects with metabolic syndrome have a lower resting metabolic rate than obese subjects without metabolic syndrome. Methods: Forty obese subjects were divided into three groups according to the presence of metabolic syndrome and type 2 diabetes; 15 non-obese healthy control subjects were also enrolled. Body composition (bio-impedance analysis) and resting metabolic rate (indirect calorimetry) were performed. Results: The group with metabolic syndrome exhibited a significantly lower resting metabolic rate adjusted for fat-free mass with respect to the control group and the obese group without metabolic syndrome (respectively: 10873 vs. 11873, po0.01 and 12373kJ/kg fat-free mass 24h, po0.01; mean7sem). The obese group with metabolic syndrome and type 2 diabetes (T2D) had a not different adjusted resting metabolic rate (11476 kJ/kg fat-free mass 24 h) with respect to other groups. Conclusions: An energy sparing condition seems to characterize non-diabetic obese subjects with metabolic syndrome

Analysis of anaerobic power in club level young rowers

Aim: To date, assessment of the anaerobic components to determine performance in rowers is not part of standard evaluation or monitoring set for training. The aim of this study was to evaluate the relation between anaerobic power output and ergometer rowing performance over 2000 meters, in a group of 14 -17 years old rowers (n = 11). Methods: Each subject performed, in three separate days, two “all-out” tests, over 20 and 60 seconds, and a 2000 meters trial, using a Concept II rowing ergometer. Mean power values over 20 sec (W20) and 60 sec (W60) were measured and compared with the time to perform the 2000 m trial (t2000). Results: Statistical analysis showed high and significant correlation between 2000 meters performance (6.90 ± 0.1 min) and anaerobic power over 20 sec (479.5 ± 93.90 watts; r = 0.941, P = 0.00002) and 60 sec (435.5 ± 64.60 watts; r = 0.964, P = 0.000002). Conclusions: The data of our study confirm that parameters of anaerobic power strongly affect the performance and that the determination of these variables by testing on rowing ergometer can be an useful tool for planning and monitoring of training in young rowers

Effetti cardiorespiratori degli sprint ripetuti in giovani calciatori

Scopo: Nel calcio la performance dipende da attività caratterizzate da sforzi di breve durata, talora ad alta intensità, con ridotti tempi di recupero. Questo tipo di sforzo può avere maggiore potenzialità aritmogena rispetto a sforzi, anche massimali, iniziati e terminati in modo graduale. Gli sprint ripetuti permettono di valutare la performance e lo stato di allenamento in giovani calciatori. Scopo del nostro lavoro è stato quello di valutare gli effetti degli sprint ripetuti sul sistema cardiorespiratorio in giovani calciatori delle rappresentative regionali siciliane della FIGC. Metodi: Sono stati esaminati 12 calciatori, di età media di 15±1 anni. Per valutare lo stato di fitness cardiorespiratoria sono stati determinati, al test da sforzo incrementale massimale al treadmill (SI), il VO2max in ml.Kg-1.min-1 (VO2maxSI) e la FCmax in bpm (FCmaxSI). Per valutare gli effetti cardiorespiratori degli sprint ripetuti, gli atleti hanno eseguito un test da sforzo al cicloergometro a freno meccanico (SR) che prevedeva 10 sprint massimali “all-out” di 6 sec, intervallati da 30 sec di recupero passivo. Nella serie dei 10 sprint, sono stati determinati il valore più elevato di VO2 in ml.Kg-1.min-1 (VO2maxSR) e di FC in bpm (FCmaxSR). Risultati: Il valore medio di VO2maxSI (56,22±3,93 ml.Kg-1.min-1) indica che i soggetti esaminati hanno un buon livello di potenza aerobica, raggiunta ad una FCmaxSI di 190±8 bpm. I dati di VO2maxSR rilevati al test degli sprint ripetuti evidenziano un valore medio di 42,67±5,57 ml.Kg-1.min-1 (70% del VO2maxSI), raggiunto ad una FCmaxSR di 175±11 bpm (92% della FCmaxSI). Conclusioni: I dati del nostro studio indicano che nei soggetti esaminati gli sprint ripetuti determinano incrementi della frequenza cardiaca rapidi, elevati e persistenti nella fase di recupero. Questo dato deve essere preso in considerazione non solo per la valutazione della performance ma anche nella formulazione dell’idoneità a praticare la disciplina sportiva del calcio

Potential Use of Superabsorbent Polymer on Drought-Stressed Processing Tomato (Solanum lycopersicum L.) in a Mediterranean Climate

Drought risk is significantly increasing as a consequence of climate change, and the Mediterranean basin will be among the most affected areas by water scarcity in Europe. The development of agronomic strategies enabling the reduction in drought stress in cultivated crops is, therefore, a crucial priority. Superabsorbent polymers (SAPs) are soil amendments capable to retain water and release it when drought occurs. In the present study, the ability of a commercial SAP to improve the drought tolerance of processing tomato (Solanum lycopersicum L.) was assessed on a commercial farm located in northern Italy. A strip plot experimental design was adopted, where three irrigation treatments (IRR100, IRR75, and IRR50, respectively, restituting 100%, 75%, and 50% of crop evapotranspiration) were combined with the application of the SAP (control vs. soil amended with SAP). No significant interaction was observed between irrigation treatments and SAP application in yield and quality traits. SAP application allowed for an average increase in tomato yield (+16.4%) and irrigation water use efficiency (IWUE) (+15.8%), determined by a higher number of marketable fruits. The irrigation strategy IRR75 + SAP maintained the same yield and quality as the full irrigation control (IRR100), increasing the IWUE by about 37%. The experiment demonstrated that, for processing tomatoes grown in the Mediterranean, it is possible to reduce the water supply by 25% when SAP amendment is applied to the soil

Race profiles of rowers during the 2014 Youth Olympic Games

Aim: Strategy plays a relevant role. The purpose of this study was to analyze the race profiles of youth athletes competing at the 2014 Youth Olympic Games over a distance of 1000-m. Methods: According to the competition outcome of sculling and sweep events, 48 male and 48 female youth (17\u201318 years) rowers were divided in medallist (W), not medallist (NW), qualified (Q) and not qualified (NQ) athletes. Time at 0\u2013500 m (T1) and 500\u20131000 m (T2) was considered. The average speed for T1 and T2 were normalized in relation to the average speed of the whole race. ANOVA for repeated measures was applied to performance 1xJ and 2-J during qualifying: 2 (sex: females vs. males) 9 2 (outcome: qualified vs. notqualified), repechages and semi-finals: 2 (sex: females vs. males) x 2 (outcome: FB vs. NFB) 9 2 (boat: 1xJ vs. 2-J) and final: 2 (sex: females vs. males) 9 2 (outcome: M vs NM) 9 2 (boat: 1xJ vs. 2-J). Results: Qualifying 1xJ show a difference (F(1, 44) = 57.76, p.001; ES = 0.75) and emerged only between competition sectors, with higher values for T1 (101.9 \ub1 1.7 %) respect to T2 (98.1 \ub1 1.7 %). Similarly, for repechages and semifinals phase 1xJ and 2-J, a difference (F(1,40) = 31.8, p.001; ES = 0.57) was found between competition sectors, with highest values for T1 (101.6 \ub1 2.3 %) and lowest for T2 (98.4 \ub1 2.3 %). For the final phase of the 1xJ and 2-J competitions, no main effect was found. In repechages and semifinals, rowers adopting a positive strategy (88 %), while during the final phase medallist (67 %) adopting a negative strategy. Conclusions: in this study emerges that athletes who adopted a negative strategy had more chance of winning respect to athletes who adopted a positive strategy. Reference Garland SW (2005) An analysis of the pacing strategy adopted by elite competitors in 2000 m rowing. Br J Sports Med 39:39\u201342

Relationship Between Heart Rate Recovery After Exercise and Maximal Oxygen Uptake in Sedentary Patients with Type 2 Diabetes

AIMS: Heart rate recovery after exercise (HRR) is an estimate of autonomic modulation of the heart, and has been shown to be inversely associated with type 2 diabetes. Type 2 diabetes is associated with decreased maximal oxygen consumption (VO2max). Aim of our study was to assess the relationship between HRR and VO2max in sedentary patients with type 2 diabetes. METHODS: Maximal exercise testing to determine VO2max (ml ∙ Kg-1 ∙ min-1) was performed in 16 sedentary patients with type 2 diabetes (DP) and in 16 age-matched sedentary healthy controls (HS). HRR (bpm) 2 min after cessation of the exercise was recorded. Simple linear regression was used to assess the relations between HRR and VO2max. RESULTS: VO2max and HRR were significantly lower in DP compared to HS (P = 0.002 and P = 0.008 respectively). A correlation between HRR and VO2max has been found, stronger in DP (r = 0.672, P = 0.004) than HS (r = 0.620, P = 0.01). CONCLUSIONS: Our study suggests that regular physical activity aimed to improve the levels of VO2max in subjects with diabetes may improve the HRR and reduce the risk of cardiovascular events

Prevalence and predictors of left ventricular hypertrophy in patients with hypertension and normal electrocardiogram

Background: Electrocardiography (ECG) has low sensitivity for detecting left ventricular hypertrophy (LVH), while echocardiography cannot be routinely performed. Design/methods: In this study we evaluate the prevalence of LVH and diastolic dysfunction in hypertensive patients with normal ECG. We excluded patients with cardiovascular (CV) diseases, diabetes, chronic kidney disease, or presenting ECG-LVH or other ECG anomalies. The enrolled 440 hypertensive patients underwent echocardiographic examination (Acuson Sequoia 512); LV mass was indexed by body surface area (LVMI) and LVH was defined as LVMI >125 g/m2 in men and >110 g/m2 in women. Diastolic function was evaluated by mitral inflow and tissue Doppler imaging (TDI). Results: The prevalence of LVH was 8.18% (95% confidence interval [CI] 5.97–11.1%). Multiple regression analysis showed that the only variable independently associated with LVH was duration of hypertension (p<0.001). The receiver operating characteristic (ROC) curve showed that duration of hypertension was a powerful predictor of LVH, with an area under the curve (AUC) of 0.878 and p<0.0001. Further, in patients with LVH the mean difference of LVMI from the cut-off value for LVH was 12.3 9.19 g/m2. Diastolic dysfunction, defined as early diastolic myocardial velocity (Em) <0.08 m/s, was detected only in 3.2% of patients. Conclusions: The prevalence of LVH among hypertensive patients with normal ECG, free of diabetes and of CV diseases is low; moreover, patients with echocardiographic LVH presented LVMI values that identified mild LVH. Few cases of impaired diastolic function were registered. We suggest that in hypertensive patients with such characteristics the echocardiographic examination should be reserved to those who present with higher duration of hypertension

Gender and the systemic hypertension-snoring association: a questionnaire-based case-control study.

Since the role of gender in the association between hypertension and snoring is unknown, we studied it while accounting for age and body mass index (BMI) as confounding variables. A questionnaire on snoring was administered to 90 hypertensive (HT) subjects (45 men and 45 women) and to 90 normotensive (NT) subjects matched for gender, age and BMI. As expected, snoring was more commonly reported by men than by women, but no significant difference was found between HT and NT men, irrespective of age. Conversely, heavy snoring was more frequently reported by HT than NT women; habitual snoring was more common among young (age50 years) HT than NT women; and heavy snoring was more common among older (age50 years) HT than NT women. These data suggest an effect of gender on the hypertension-snoring association: in men, snoring may be accounted for by age and BMI whether or not hypertension is present, whereas in women the natural history of snoring appears different and more severe in HT than in NT. Although the mechanism(s) responsible for the differences between men and women are obscure at present, gender may be an important variable in the systemic hypertension-snoring association