EVALUATION OF CARDIORRESPIRATORY FITNESS IN PATIENTS WITH LUNG CANCER SUBMITTED TO LUNG RESECTION SURGERY

Patients with lung cancer who undergo lung resection surgery, should undergo a range of evaluations prior to this. One of the fundamental elements is the knowledge of cardiorespiratory fitness (CRF), mostly measured as maximum oxygen consumption (VO2max) or as peak oxygen consumption (VO2peak); being of great importance because of its relation with perioperative morbidity and mortality's risk of these patients, therefore, determinant in clinical decisions. The cardiopulmonar test (CPET) is the 'gold standard' for knowledge of CRF and the physiological state of the patient prior to surgery; being a valuable tool, wich allows to identify those patients who have less than 10 ml/kg/min who could have a higher risk of perioperative complications, as well as mortality. However, it's not considered a primary evaluation, and does not overcome spirometry and the oxygen diffusion test; thus it is a test that requires great implementation and resources, both human and economic. There are publications of another alternative for its evaluation, although still with limited evidence and without greater concordance for knowledge of the CRF, such as Stair Climbing Test (SCT) y Shuttle Walking Test (SWT) which are considered by clinical guidelines, even when these two main ones have limitations both in their internal assessment, as well as in protocols, and its importance as perioperative prognosis factor. We can find different alternatives, however, new studies that follow this research line are necessary, together with the use and generation of tests that create greater impact, in research area as well as in clinic

IDEAL TREATMENT FOR INSULIN RESISTANCE AND PREDIABETES; ?METFORMIN OR EXERCISE?

The present review arises on the need to know the current position in relation to the optimal treatment of insulin resistance (IR), which is defined as a suboptimal response of this hormone, and prediabetes (preDT2), defined as an alteration of glucose at blood level, known as the previous step to Diabetes Mellitus type 2 (DT2). We specifically compared physical activity with the most widely used and studied drug on the market, Metformin. For this study access to databases of related articles, in order to collect, summarize and present the therapeutic options and the results that have been the different working groups, and thus know the best work strategy and planning for this type of patients. We obtained that change of lifestyles, mainly the performance of physical activity over 150 minutes per week, shows good results, decreasing the transition from preDT2 to DT2, compared to the exclusive use of metformin. Exercise also decreases body weight, which is associated with a decrease in the passage from preDT2 to DT2. On the other hand, it has observed that, by combining both therapies, metformin and exercise, no statistically significant improvements are achieve comparing to exercise alone. In addition, the use of metformin in prediabetics results in a statistically significant reduction in oxygen consumption, maximum heart rate and duration of the exercise