Variabilitat de la freqüència cardíaca com a indicador de salut en esport: validació amb un qüestionari de qualitat de vida (SF-12)

Introducció i objectiu: L'anàlisi de la variabilitat de la freqüència cardíaca (VFC) s'utilitza cada vegada més en l'àmbit de la medicina de l'esport per avaluar l'adaptació a l'entrenament dels esportistes. El nostre objectiu és validar l'anàlisi de la VFC com a indicador de salut, comparant els paràmetres de VFC amb les puntuacions de l'SF-12 en una mostra de persones sanes. Mètode: Estudi experimental amb 32 subjectes sans, 18 homes i 14 dones (26,19 anys de mitjana). Es va utilitzar el qüestionari SF-12 per avaluar la qualitat de vida i un pulsòmetre telemètric Polar S810i per enregistrar la VFC a partir de l'interval RR. Els paràmetres de VFC es van obtenir mitjançant el programa Polar Precision Performance. Resultats: Els paràmetres RMSSD, pNN50 i HF que mostren la VFC es correlacionen significativament i positivament amb els valors de percepció de salut a nivell físic, obtinguts en l'escala de sumari físic, en la dimensió de rol físic i en l'escala total de l'SF-12. Els subjectes del grup que perceben més salut són els que presenten més variabilitat de la freqüència cardíaca. Una més gran activació vagal en repòs es relaciona amb una més alta qualitat de vida en relació amb la salut. Conclusions: Els resultats del nostre estudi confirmen que l'anàlisi de la VFC és un bon marcador de l'estat de salut i pot ajudar a diagnosticar ràpidament i amb facilitat (en repòs, d'una manera no invasiva) estats d'estrès (efecte cremat -burnout-, fatiga, sobreentrenament, esgotament o ansietat) en la població general i, especialment, en esportistes d'alt rendiment

Correction : Chaparro et al. Incidence, Clinical Characteristics and Management of Inflammatory Bowel Disease in Spain: Large-Scale Epidemiological Study. J. Clin. Med. 2021, 10, 2885

The authors wish to make the following corrections to this paper [...]

Incidence, Clinical Characteristics and Management of Inflammatory Bowel Disease in Spain : Large-Scale Epidemiological Study

(1) Aims: To assess the incidence of inflammatory bowel disease (IBD) in Spain, to describe the main epidemiological and clinical characteristics at diagnosis and the evolution of the disease, and to explore the use of drug treatments. (2) Methods: Prospective, population-based nationwide registry. Adult patients diagnosed with IBD-Crohn's disease (CD), ulcerative colitis (UC) or IBD unclassified (IBD-U)-during 2017 in Spain were included and were followed-up for 1 year. (3) Results: We identified 3611 incident cases of IBD diagnosed during 2017 in 108 hospitals covering over 22 million inhabitants. The overall incidence (cases/100,000 person-years) was 16 for IBD, 7.5 for CD, 8 for UC, and 0.5 for IBD-U; 53% of patients were male and median age was 43 years (interquartile range = 31-56 years). During a median 12-month follow-up, 34% of patients were treated with systemic steroids, 25% with immunomodulators, 15% with biologics and 5.6% underwent surgery. The percentage of patients under these treatments was significantly higher in CD than UC and IBD-U. Use of systemic steroids and biologics was significantly higher in hospitals with high resources. In total, 28% of patients were hospitalized (35% CD and 22% UC patients, p < 0.01). (4) Conclusion: The incidence of IBD in Spain is rather high and similar to that reported in Northern Europe. IBD patients require substantial therapeutic resources, which are greater in CD and in hospitals with high resources, and much higher than previously reported. One third of patients are hospitalized in the first year after diagnosis and a relevant proportion undergo surgery

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Exercise motivation in university community members: a behavioral intervention

El objetivo de este estudio es analizar los cambios en el nivel de ejercicio físico y en los motivos y barreras para su práctica, desde la fase de línea de base hasta la fase de seguimiento, después de una intervención cognitivo-conductual para incrementar el ejercicio. 75 miembros de nuestra comunidad universitaria aceptaron participar en la línea de base (43 sujetos del grupo control y 32 del experimental). Todos ellos recibieron feed-back cognitivo. Sólo el grupo experimental recibió feed-back conductual y un ticket de libre acceso a un centro deportivo con entrenamiento personal para facilitar su adherencia al ejercicio. Los resultados sugieren que una combinación de técnicas cognitivo-conductuales resulta una estrategia eficiente para incrementar el nivel de ejercicio. Los resultados también muestran que durante los primeros estadios de cambio de la conducta de ejercicio domina la motivación extrínseca y que la motivación intrínseca es importante para la progresión hacia el mantenimiento. Los sujetos que disminuyeron su nivel de ejercicio incrementaron su motivación extrínseca hacia el ejercicio y los sujetos que aumentaron su nivel de ejercicio disminuyeron las barreras relacionadas con la motivación intrínseca. Estos resultados indican que para facilitar la adherencia al ejercicio los participantes necesitan recibir retroalimentación sobre sus motivos hacia el ejercicio combinada con asesoramiento sobre la mejora de su condición física. Esta combinación podría ayudar a eliminar algunas barreras que dificultan la posibilidad de adherirse a un estilo de vida activo y saludable

Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)

In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field