Low-intensity resistance exercise training increases lower limb force in healthy retirees

INTRODUCTION: Aging is associated with decreasing muscle strength. Older people who have never done resistance work in a gym require gradual training programs to help them increasing confidence on this type of training. The use of low intensity resistance exercise with slow movements and tonic force improvement has been proposed as an effective method to increase muscular strength. There is little literature on the effect of intensity training on 30% of one repetition maximum (RM). PURPOSE: To establish the changes in the strength of upper and lower limb force after participating in a 10 week low-intensity resistance exercise for a group of healthy retirees aged between 50 and 70 years. METHODS: Quasi-experimental design, with two measurements. Fifty-eight participants were separated into two groups according to their available schedule. The experimental group received low-intensity resistance training for ten weeks, three times a week, with an intensity of 30 to 60% RM. The control group received no training. Physical tests applied to both groups were: handgrip strength with digital dynamometer, Short Physical Performance Battery (SPPB) and 8-Foot up and go test (FUGT).RESULTS: Forty nine participants completed the study (total dropout rate was 16%) from which 57% were women. Participants in the experimental group (n = 31) had improvements in SPPB and FUGT tests (p \u3c.05). Without changes in handgrip strength. On the other hand, any changes were observed in the control group. CONCLUSION: The results indicate that a low-intensity resistance training (30% 1RM) is a useful method to increase muscle strength of lower limbs in healthy older adults. Due to the interference effect of training, more time is required to observe changes in the dynamic strength of the upper limbs. This type of training program is useful for promoting functionality in older adults reluctant to resistance training

Effects of smoking on vital capacity in healthy students

INTRODUCTION: Although the tobacco consumption has been reported to obstruct the effects of physical culture in young adults, there are few reports that include physical and laboratory evidence of this. Health education appears not to prevent impairment of the vital capacity associated with tobacco consumption. PURPOSE: The purpose of this study was estimate the effect of tobacco consumption on vital capacity after four months of participation in a theoretical-practical program on movement fundamentals.METHODS: Preexperimental design of two measurements. Lung function and a physical test were performed on seventeen healthy students. Course-Navette test was carried out to estimate vital capacity (heart rate at rest, maximum heart rate, physical level, VO2 max, distance and average speed). Forced expiratory volume in one second (FEV1) was measured by Welch Allyn Schiller spirometer. The sample was divided on the consumption of cigarettes (12 consumers vs. 5 abstainers). T-tests were used to evaluate the differences between groups. RESULTS: Participants were men of 20.94 years (SD = 2.69, 18-19 years) with normal body complexion (Body mass index = 24.51 kg/m 2 (SD = 1.69). There were no baseline differences between groups regarding age or body composition (p \u3e .05). Differences in all parameters related to vital capacity were observed in the abstainers group (p \u3c .01), except for maximal heart rate and resting heart rate (p \u3e .05). The smokers group decreased their results in both tests but without significant differences. CONCLUSION: Tobacco consumption affected the vital capacity of young adults despite the participation in theoretical-practical program of fundamentals of the movement. Tobacco abstinence coupled with participation in an educational program increased vital capacity measured with a physical and a laboratory test

The management of acute venous thromboembolism in clinical practice. Results from the European PREFER in VTE Registry

Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in Europe. Data from real-world registries are necessary, as clinical trials do not represent the full spectrum of VTE patients seen in clinical practice. We aimed to document the epidemiology, management and outcomes of VTE using data from a large, observational database. PREFER in VTE was an international, non-interventional disease registry conducted between January 2013 and July 2015 in primary and secondary care across seven European countries. Consecutive patients with acute VTE were documented and followed up over 12 months. PREFER in VTE included 3,455 patients with a mean age of 60.8 ± 17.0 years. Overall, 53.0 % were male. The majority of patients were assessed in the hospital setting as inpatients or outpatients (78.5 %). The diagnosis was deep-vein thrombosis (DVT) in 59.5 % and pulmonary embolism (PE) in 40.5 %. The most common comorbidities were the various types of cardiovascular disease (excluding hypertension; 45.5 %), hypertension (42.3 %) and dyslipidaemia (21.1 %). Following the index VTE, a large proportion of patients received initial therapy with heparin (73.2 %), almost half received a vitamin K antagonist (48.7 %) and nearly a quarter received a DOAC (24.5 %). Almost a quarter of all presentations were for recurrent VTE, with >80 % of previous episodes having occurred more than 12 months prior to baseline. In conclusion, PREFER in VTE has provided contemporary insights into VTE patients and their real-world management, including their baseline characteristics, risk factors, disease history, symptoms and signs, initial therapy and outcomes

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Adaptation of sea turtles to climate warming: Will phenological responses be sufficient to counteract changes in reproductive output?

© 2023 The Authors. Global Change Biology published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.Sea turtles are vulnerable to climate change since their reproductive output is influenced by incubating temperatures, with warmer temperatures causing lower hatching success and increased feminization of embryos. Their ability to cope with projected increases in ambient temperatures will depend on their capacity to adapt to shifts in climatic regimes. Here, we assessed the extent to which phenological shifts could mitigate impacts from increases in ambient temperatures (from 1.5 to 3°C in air temperatures and from 1.4 to 2.3°C in sea surface temperatures by 2100 at our sites) on four species of sea turtles, under a “middle of the road” scenario (SSP2-4.5). Sand temperatures at sea turtle nesting sites are projected to increase from 0.58 to 4.17°C by 2100 and expected shifts in nesting of 26–43 days earlier will not be sufficient to maintain current incubation temperatures at 7 (29%) of our sites, hatching success rates at 10 (42%) of our sites, with current trends in hatchling sex ratio being able to be maintained at half of the sites. We also calculated the phenological shifts that would be required (both backward for an earlier shift in nesting and forward for a later shift) to keep up with present-day incubation temperatures, hatching success rates, and sex ratios. The required shifts backward in nesting for incubation temperatures ranged from −20 to −191 days, whereas the required shifts forward ranged from +54 to +180 days. However, for half of the sites, no matter the shift the median incubation temperature will always be warmer than the 75th percentile of current ranges. Given that phenological shifts will not be able to ameliorate predicted changes in temperature, hatching success and sex ratio at most sites, turtles may need to use other adaptive responses and/or there is the need to enhance sea turtle resilience to climate warming.Peer reviewe

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified