Effects of a remotely supervised resistance training program on muscle strength and body composition in adults with cystic fibrosis: Randomized controlled trial.

INTRODUCTION: Among the limited studies on physical exercise interventions in adults with cystic fibrosis (CF), few have specifically addressed the improvement of peripheral muscle strength and body fat-free mass. The aim of this study was to examine the impacts of a remotely supervised, individualized 8-week resistance training program of moderate to high intensity on strength and body composition in these subjects. METHODS: This was a randomized controlled trial performed in adults with CF. The exercise group (EX) performed three 1-h resistance training sessions per week over 8 weeks. The control group (CON) followed the physical activity recommendations of their physician. The main outcomes were muscle strength and body composition, with secondary measures including pulmonary function and quality of life. Two-way repeated measures analysis was used. RESULTS: In 23 participants (age 32.13 ± 7.72 years), the intervention showed a significant beneficial effect on leg press strength, with a large effect size, both in absolute (p = 0.011; η p 2 $$ {\eta}_{\mathrm{p}}^2 $$ = 0.281) and relative (p = 0.007; η p 2 $$ {\eta}_{\mathrm{p}}^2 $$ = 0.310) terms. Large intervention effects were observed on total fat mass (p < 0.001; η p 2 $$ {\eta}_{\mathrm{p}}^2 $$ = 0.415), body adiposity index (p < 0.001; η p 2 $$ {\eta}_{\mathrm{p}}^2 $$ = 0.436), and fat mass index (p < 0.001; η p 2 $$ {\eta}_{\mathrm{p}}^2 $$ = 0.445), all showing reduction in the EX group. In addition, significant large size effects were detected on total fat-free mass (p = 0.046; η p 2 $$ {\eta}_{\mathrm{p}}^2 $$ = 0.177), trunk fat-free mass (p = 0.039; η p 2 $$ {\eta}_{\mathrm{p}}^2 $$ = 0.188), and fat-free mass index (p = 0.048; η p 2 $$ {\eta}_{\mathrm{p}}^2 $$ = 0.174), all favoring exercise. No significant effects were observed on pulmonary function and quality of life. CONCLUSIONS: An 8-week remotely supervised resistance training program, with moderate to high intensity, effectively improved lower limb muscle strength and body composition.

Effect of Physical Exercise Programs Based on Mobile Health and Ecological Momentary Assessment on the Physical and Mental Health, Cognitive Functions, and Social Environment of Adults in Developing Countries: A Systematic Review.

Background and Objectives: Although there is strong evidence of the positive effects of physical exercise on health, adherence to face-to-face exercise programs in the adult population is low, identifying several barriers that hinder their practice. There is research that demonstrates the viability of physical exercise programs with the use of Mobile Health in Ecological Momentary Assessment (EMA) mode, which contributes to overcoming many reported barriers. To synthesize the methodological characteristics and health effects of physical exercise programs based on mobile health in EMA modality in adults in developing countries. Materials and Methods: This systematic review was conducted according to guidelines established by the PRISMA statement in APA PsycArticles and CINAHL databases by EBSCOhost, Cochrane Library, PubMed, and Web of Science for articles published between 2008 and March 2024. Results: Telephone counseling on clinical-behavioral factors is believed to reduce morbidity and mortality in developed countries, but this aspect is not explored in developing countries. We included nine randomized controlled trials with a total of 4394 male and female participants aged 18 to 60 years. The interventions were mainly carried out by text messages, lasting between 20 to 80 min per session, 3 to 5 days per week, and most were carried out over 12 months. The interventions on the variables of physical activity, nutrition, and medical assessments showed significant effects, and variables such as quality of life and anthropometric measurements were not significant in most studies. Conclusions: This systematic review included studies from different developing countries, the most common diseases being diabetes, overweight, obesity, and hypertension. All the studies used mobile devices as the technology, finding a profile of the adults studied, as well as the characteristics of exercise programs based on mobile health in EMA modality.

Evaluation of a Zingiber officinale and Bixa orellana Supplement on the Gut Microbiota of Male Athletes: A Randomized Placebo-Controlled Trial.

The gut microbiota has emerged as a factor that influences exercise performance and recovery. The present study aimed to test the effect of a polyherbal supplement containing ginger and annatto called "ReWin(d)" on the gut microbiota of recreational athletes in a pilot, randomized, triple-blind, placebo-controlled trial. Thirty-four participants who practice physical activity at least three times weekly were randomly allocated to two groups, a ReWin(d) group or a maltodextrin (placebo) group. We evaluated the gut microbiota, the production of short-chain fatty acids, and the serum levels of interleukin-6 and lipopolysaccharide at baseline and after 4 weeks. Results showed that ReWin(d) supplementation slightly increased gut microbiota diversity. Pairwise analysis revealed an increase in the relative abundance of Lachnospira (ß-coefficient = 0.013; p = 0.001), Subdoligranulum (ß-coefficient = 0.016; p = 0.016), Roseburia (ß-coefficient = 0.019; p = 0.001), and Butyricicoccus (ß-coefficient = 0.005; p = 0.035) genera in the ReWin(d) group, and a decrease in Lachnoclostridium (ß-coefficient = - 0.008; p = 0.009) and the Christensenellaceae R7 group (ß-coefficient = - 0.010; p < 0.001). Moreover, the Christensenellaceae R-7 group correlated positively with serum interleukin-6 (ρ = 0.4122; p = 0.032), whereas the Lachnospira genus correlated negatively with interleukin-6 (ρ = - 0.399; p = 0.032). ReWin(d) supplementation had no effect on short-chain fatty acid production or on interleukin-6 or lipopolysaccharide levels.

Effects of Physical Training on Heart Rate Variability in Children and Adolescents with Chronic Diseases: A Systematic Review and Meta-analysis.

This study analyzed the effects of physical training programs on heart rate variability, as a measure of sympathovagal balance, in children and adolescents with chronic diseases. Relevant articles were systematically searched in Pubmed, Science Direct, Web of Science, Scopus, Google Scholar and Embase scientific databases. We performed a meta-analysis using an inverse variance heterogeneity model. Effect size calculation was based on the standardized mean differences between pre- and post-intervention assessments, assuring at least a single-group repeated-measures model for each extracted group. Ten studies (252 participants) were included, seven in obese subjects, two in type-1 diabetes, and one in cerebral palsy. When time-domain variables were analyzed, exercise was found to moderately increase RMSSD (SMD=0.478; 95%CI: 0.227 to 0.729; p<0.001), SDNN (SMD=0.367; 95%CI: 0.139 to 0.595; p=0.002) and pNN50 (SMD=0.817; 95%CI: 0.139 to 0.595; p=0.002). As for frequency-domain variables, exercise presented a moderate increasing effect on HF (SMD=0.512; 95%CI: 0.240 to 0.783; p<0.001), a negligible effect for LF (SMD=0.077; 95%CI: -0.259 to 0.412; p<0.001) and a non-significant reduction for LF/HF (SMD=-0.519; 95%CI: -1.162 to 0.124; p=0.114). In conclusion, physical training programs are able to modulate heart rate variability in children and adolescents with chronic diseases, affecting mainly the time-domain variables.

Acid spill impact on Sonora River basin. Part I. sediments: Affected area, pollutant geochemistry and health aspects.

The Sonora River and its tributary streams (Tinajas, Bacanuchi) were impacted in 2014 by an acid solution spill (approximately 40,000 m3). This study aims to presents a clear and supported overview to determining the spill's consequences on the environment and the people inhabiting the area. The elements quantified were those found in the spilled solution: Al, As, Cu, Fe, Mn, Pb, and Zn. Potential Toxic Element (PTE) concentration means from 187 sediment samples were, in mg.kg-1: Al = 7,307, As = 16.6, Ba = 128 Cu = 106 Fe = 15,764, Mn = 566, Pb = 46 and Zn = 99. Differences between PTE concentrations in the most impacted sediments and those of the local baseline, sampled in streams not affected by the spill and regional baseline values, were not statistically significant. The similarity of PTE concentrations among sediments may be explained by natural geological enrichment, historical mining impacts, and a low increase of PTE in sediments after the acid spill because of natural and anthropogenic attenuation. Mainly heavy rains, natural pedogenic carbonates, and remedial work done by the mining company (retaining dam, adding lime; precipitation, collecting formed solids, and transport to the mine). The Contamination Factor (C.F.), Enrichment Factor (E.F.), and Geo-accumulation Index (Igeo) were determined. The C.F. indicated low and moderate contamination in all elements. Cu exhibited the highest E.F., from moderate to significant enrichment. The Igeo generally ranged from -0.02 to 0.15. Cu and Zn were classified as moderately to heavily contaminated. In local baseline sediments, the Cu C.F. varied from moderate to very high contamination, the Cu E.F. from moderate to significant enrichment, while the As, and Pb Igeo ranged from uncontaminated to moderately contaminated. In general, normalization demonstrated a high degree of Cu enrichment at sites 1-14. Sequential extractions indicated that only Cu was found in all fractions, including a significant exchangeable fraction in the very impacted sediments (1-14). The other PTEs were distributed between the Fe/Mn oxide fraction and the residual phase. Principal Components Analysis for PTE concentrations indicated three different groups with similar geochemical patterns and allowing to identify the PTE potentially sources: the first sediments from sites 1-14 were the impacted sediments in accordance with pH and electrical conductivity results, the second group from sites 15-20 showed characteristics of the mineralized environment, and the third from sites 21-30 were unrelated to the spillage. The area impacted by the acid solution spill reached approximately 30 km downstream, just roughly 15% of the initially considered area.

Genetic variations associated with non-contact muscle injuries in sport: A systematic review.

INTRODUCTION: Non-contact muscle injuries (NCMI) account for a large proportion of sport injuries, affecting athletes' performance and career, team results and financial aspects. Recently, genetic factors have been attributed a role in the susceptibility of an athlete to sustain NCMI. However, data in this field are only just starting to emerge. OBJECTIVES: To review available knowledge of genetic variations associated with sport-related NCMI. METHODS: The databases Pubmed, Scopus, and Web of Science were searched for relevant articles published until February 2021. The records selected for review were original articles published in peer-reviewed journals describing studies that have examined NCMI-related genetic variations in adult subjects (17-60 years) practicing any sport. The data extracted from the studies identified were as follows: general information, and data on genetic polymorphisms and NCMI risk, incidence and recovery time and/or severity. RESULTS: Seventeen studies examining 47 genes and 59 polymorphisms were finally included. 29 polymorphisms affecting 25 genes were found significantly associated with NCMI risk, incidence, recovery time, and/or severity. These genes pertain to three functional categories: (i) muscle fiber structural/contractile properties, (ii) muscle repair and regeneration, or (iii) muscle fiber external matrix composition and maintenance. CONCLUSION: Our review confirmed the important role of genetics in NCMI. Some gene variants have practical implications such as differences of several weeks in recovery time detected between genotypes. Knowledge in this field is still in its early stages. Future studies need to examine a wider diversity of sports and standardize their methods and outcome measures.

Heavy metal pollution of street dust in the largest city of Mexico, sources and health risk assessment.

In large industrialized cities, tons of particles containing heavy metals are released into the environment and accumulate on street surfaces. Such particles cause a potential risk to human health due to their composition and size. The heavy metal contamination levels, main emission sources, and human health risks were identified in 482 samples of street dust. Heavy metal concentrations were obtained by microwave-assisted acid digestion and ICP-OES. The results indicated that street dust in Mexico City is contaminated mainly with Pb, Zn, and Cu, according to the contamination factor and the geoaccumulation index. The pollution load index of the street dust was made with the concentrations of Pb, Zn, Cu, Cr, and Ni. The main sources of Pb, Zn, Cu, and Cr are anthropic, probably due to vehicular traffic. The highest levels of Cr and Pb in urban dust represent a health risk for children. Contamination limits were proposed for heavy metals in street dust of Mexico City. These limits might be useful to generate and apply public policies to decrease anthropic emissions of the heavy metals studied, particularly Cr and Pb.

Acute effect of orange chromatic environment on perceived health status, pain, and vital signs during chemotherapy treatment.

PURPOSE: The study is aimed at assessing the acute effect of orange color and natural light exposure on cancer patients during chemotherapy sessions. Warmer environments and rooms receiving more sunlight hours were expected to impact vital signs, quality of life, and pain symptoms. METHODS: We used a single-group repeated-measures clinical trial design. For the purpose of the study, chemotherapy rooms were modified based on two experimental factors: color (white vs. orange) and sunlight orientation (south vs. north). On four consecutive sessions, cancer patients were randomly assigned to one of the following conditions: orange-north, orange-south, white-north, and white-south. They received chemotherapy per standard of care. The following outcomes were assessed: blood pressure, body temperature, heart rate, and European Quality of Life Five-Dimension Five-Level Scale Questionnaire (EUROQOL-5D-5L) including the visual analogue scale (EQ-VAS). RESULTS: Statistically significant beneficial effect of orange color room in self-rated health was found (p = 0.036, d = 0.28). Small differences in other parameters (body temperature, d = 0.34; diastolic blood pressure, d = 0.37; systolic blood pressure, d = 0.28) did not reach statistical significance. No differences were found based on room orientation. CONCLUSIONS: Compared with a cool-color design, a warm-color living environment could have a positive effect on patients' well-being during chemotherapy sessions. Although the clinical effect size on perceived health status and vital signs could be considered small, the cost-effectiveness analysis would support the use of the proposed configurations. More research is still needed. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03873519.

Spatial distribution of manganese concentration and load in street dust in Mexico City.

OBJECTIVE: To obtain a first indication of the distribution and extent of manganese (Mn) contamination in Mexico City. Mn concentration and load in street dust were analyzed in order to reveal the most contaminated areas. MATERIALS AND METHODS: 482 samples of street dust were analyzed through inductively coupled plasma-optical emission spectroscopy. The contamination factor (CF), the geoaccumulation index (Igeo) and the spatial interpolations of the kriging indicator were calculated. RESULTS: A slight influence of anthropogenic activities is detected on the Mn content of street dust. The highest levels of pollution by concentra- tion (Igeo=uncontaminated to moderately contaminated) are grouped towards the city's north (industrial) and center (commercial and high traffic) areas. The areas with the high- est Mn load were located towards the east and northwest areas (Igeo=moderately contaminated). CONCLUSIONS: These findings will serve as a baseline to assess future variations in Mn content in Mexico City's environment.

OBJETIVO: Obtener una primera aproximación sobre la distribución espacial de la contaminación por manganeso (Mn) en la Ciudad de México. Se analizó la concentración y carga de Mn en el polvo de la calle para identificar las áreas más contaminadas. MATERIAL Y MÉTODOS: 482 muestras de polvo de la calle fueron analizadas con espectroscopía de emisión por plasma de acoplamiento inductivo. Se calculó el factor de contaminación, índice de geoacumulación, y las interpolaciones espaciales del indicador kriging. RESULTADOS: Existe una ligera influencia de actividades antropogénicas en el contenido de Mn del polvo de la calle. Los niveles más altos de contaminación por concentración (Igeo=no contaminado a moderadamente contaminado) se agruparon en el norte (industrial) y centro (comercial y de alto tráfico) de la ciudad. Las áreas con las cargas de Mn más altas estuvieron al este y noroeste (Igeo=moderadamente contaminado), donde había más polvo. CONCLUSIONES: Estos resultados servirán como punto de referencia para evaluar variaciones futuras en el contenido de Mn en la Ciudad de México.

Effects of a short workplace exercise program on body composition in women: A randomized controlled trial.

Physical inactivity and poor diet cause alterations in body composition, which in turn increases risk factors for cardiovascular and metabolic diseases. Sixty-three women from different work environments were randomly assigned to an intervention (n = 34) or control (n = 29) group. The intervention was a short-term aerobic exercise program (12 weeks) at their workplace. Participants assigned to the control group did not perform any form of physical exercise. Body composition was measured by dual-energy X-ray absorptiometry (DXA). Diet was assessed using the Mediterranean Diet Quality Questionnaire (KIDMED) and nutrient balance by the Food Frequency Questionnaire. Researchers suggest that a short-term aerobic exercise program produces beneficial effects on body composition.

Educational experiences in a master of health professions education program at the National Autonomous University of Mexico: A qualitative study.

Background: Medical schools and healthcare institutions need leaders with formal training in education, in order to provide quality medical teaching. An answer to this need lies in the graduate programs of health professions education. Many programs exist, but there is a dearth of publications about their educational processes and experiences. The purpose of this study was to explore the teaching and learning experiences of students, teachers, and graduates of the Master in Health Professions Education (MHPE) program at the National Autonomous University of Mexico (UNAM). Methods: A qualitative approach was used with focus group discussions with students, graduates, and teachers, to explore their opinions, feelings, and experiences about the program. Purposeful sampling of participants was done. Focus group guides were developed for the different study groups; testimonies were codified and categorized with axial coding and a constant comparison method. Results: Testimonies from 19 participants in three focus groups were obtained (five graduates, seven current students, and seven teachers). The data were grouped in seven thematic categories: expectations, feedback of research projects, the tutorial process, teaching strategies, usefulness of what was learned, professional development, and assessment. Positive elements of the program were identified as well as areas in need of improvement. Discussion: The MHPE program at UNAM has been a positive experience for students and mostly fulfilled their expectations, they learned the basic theories and practical aspects of teaching, learning, and assessment in the health professions. Some areas need improvement, such as tutor performance and timely feedback to the students. Graduates think the competencies acquired in the program are useful for their professional practice. This information will be used to improve the program. There is a need to meet international standards in MHPE programs.

[Competence development in undergraduate medical schools: a model with entrusted professional activities]. / Desarrollo de competencias en el pregrado: un modelo con actividades profesionales confiables (APROC).

INTRODUCTION: Today´s relevant educational models emphasize that a great part of learning be situated and reflexive; one of those is the Entrusted Professional Activities model. The study objective was to develop a model that integrates Entrusted Professional Activities with a medical school curriculum. METHODS: From October 2012 a multidisciplinary group met to develop a model with the specialty of obstetrics and gynecology. From two published models of Entrusted Professional Activities and the curriculum of a school of medicine, blocks, units, and daily clinical practice charts were developed. The thematic content of the curriculum was integrated with the appropriate milestones for undergraduate students and the clinical practice needed to achieve it. RESULTS: We wrote a manual with 37 daily clinical practice charts for students (18 of gynecology and 19 of obstetrics) and 37 for teachers. Each chart content was the daily clinical practice, reflection activities, assessment instruments, and bibliography. CONCLUSIONS: It is feasible to combine a model of Entrusted Professional Activities with an undergraduate curriculum, which establishes a continuum with postgraduate education.

Eight years' experience with a Medical Education Journal Club in Mexico: a quasi-experimental one-group study.

BACKGROUND: A time-honored strategy for keeping up to date in medicine and improving critical appraisal skills is the Journal Club (JC). There are several reports of its use in medicine and allied health sciences but almost no reports of JC focused on medical education. The purpose of the study is to describe and evaluate an eight years' experience with a medical education Journal Club (MEJC). METHODS: We started a monthly medical education JC in 2006 at UNAM Faculty of Medicine in Mexico City. Its goal is to provide faculty with continuing professional development in medical education. A discussion guide and a published paper were sent 2 weeks before sessions. We reviewed the themes and publication types of the papers used in the sessions, and in June-July 2014 administered a retrospective post-then-pre evaluation questionnaire to current participants that had been regular attendees to the JC for more than 2 years. The retrospective post-then-pre comparisons were analyzed with Wilcoxon signed-rank test. Effect sizes were calculated for the pre-post comparisons with Cohen's r. RESULTS: There have been 94 MEJC sessions until July 2014. Average attendance is 20 persons, a mix of clinicians, educators, psychologists and a sociologist. The articles were published in 32 different journals, and covered several medical education themes (curriculum, faculty development, educational research methodology, learning methods, assessment, residency education). 22 Attendees answered the evaluation instrument. The MEJC had a positive evaluation from good to excellent, and there was an improvement in self-reported competencies in medical education literature critical appraisal and behaviors related to the use of evidence in educational practice, with a median effect size higher than 0.5. The evaluation instrument had a Cronbach's alpha of 0.96. CONCLUSIONS: A periodic Medical Education Journal Club can improve critical appraisal of the literature, and be maintained long-term using evidence-based strategies. This activity is a useful adjunct to the scholarship of teaching.

Anthropometric changes in adolescents with anorexia nervosa in response to resistance training.

PURPOSE: The follow-up of anthropometric percentiles such as triceps and mid-thigh skinfold thickness (TSF, MTSF), mid-upper arm and mid-thigh circumferences (MUAC, MTC), and arm and mid-thigh muscle areas (AMA, MTMA) after a resistance training might allow for detecting nutritional progress of fat and muscular tissue during the treatment of anorexia nervosa restricting (AN-R) type patients. METHODS: A total of 44 AN-R patients were randomized for control (CG 13.0 ± 0.6 years) and intervention (IG 12.7 ± 0.7 years) groups after hospitalization. The intervention group underwent a resistance training program of 8 weeks following the guidelines for healthy adolescents (3 days/week; 70 % of 6 RM). All measurements were obtained prior to starting the program (PRE) and after 8 weeks of training (POST) in both groups. TSF, MTSF, MUAC, and MTC were measured, and AMA and MTMA were calculated. Data were matched with percentile tables for general population. Changes were assessed using statistical tests for categorical data. RESULTS: The distribution of percentile categories within the groups did not differ statistically after 8 weeks (p > 0.05). After training, 73 % of the patients were at the same percentile interval of MUAC, 18 % higher and 9 % lower, while 30 % of CG was at lower percentile categories. Further, 54 % of the IG patients remained at the same percentile interval of MTC after training, and 36 % higher, while 20 % were at lower categories in the CG. The AMA increased (32 %) after training or remained at the same interval (59 %) in the IG, while the IG showed greater frequency of percentile decreases (45 %). CONCLUSIONS: Anthropometric measurements could be useful for assessing muscle status in AN-R patients during the treatment process. However, exact standard deviation scores should be used instead of percentile categories to increase the sensitivity to changes in TSF, MTSF, MUAC, MTC or AMA.

Resistance training enhances muscular performance in patients with anorexia nervosa: a randomized controlled trial.

OBJECTIVE: Low-intensity exercise applied in anorexia nervosa patients has been shown to have a harmless effect on body composition and to effect short-term improvements in muscular strength and agility. The aim of this study was to determine the effects of a high-intensity resistance training program designed for adolescents to improve strength and agility in anorexia nervosa restricting-type patients (AN-R). METHODS: From a total of 36 female patients with AN-R, one group (intervention, n = 18) underwent a supervised high-intensity resistance training program lasting 8 weeks, and the other group with no exercise (control, n = 18). Body weight, body mass index, whole-body muscular strength, and agility were assessed before, after, and 4 weeks after training (detraining). RESULTS: Leg-press, bench-press, and lateral row tests improved significantly (p < 0.001) after 8 weeks of training compared with controls. Improvements were maintained after the detraining period. The training program also showed beneficial effects on agility. DISCUSSION: A high-intensity resistance training program adapted to the recommendations for adolescents in AN-R patients was effective and safe, improving muscular strength in the whole body and the ability to perform daily tasks. However, long-term maintenance of gains seems to be linked to the continuance of training or the use of a maintenance program.

The multifactorial approach and the food allergen-specific substitutive diet as a tool to manage and ameliorate adverse reactions to foodstuffs in adulthood: study protocol for a randomized controlled trial-the ALASKA study.

BACKGROUND: Adverse reactions to foodstuffs (ARFS), specifically food allergy (FA) and food intolerance (FI), are increasing worldwide and represent a major public health concern. Thus, ARFS management, its identification, evaluation, and intervention, must provide a comprehensive solution. OBJECTIVES: (a) To develop a multifactorial strategy for ARFS management in adults with FA and/or FI; (b) to describe the multiple influential variables in ARFS within the realm of ARFS management; and (c) to design a personalized food allergen-specific substitutive diet (FASSD), as a 6-month dietary treatment option for adults with ARFS and as a component of ARFS management. METHODS: The ALASKA study will consider the following main variables as part of the ARFS management: (1) demographics and clinical information; (2) symptomatology, food and beverages intake and physical activity; (3) hematobiochemical study; (4) immunology; (5) enzymatic activity; (6) anthropometry, body composition, and physical fitness; (7) QoL; (8) 6-month intervention; (9) end of the study; and (10) other assessments. The FASSD will be designed with special emphasis on the commonly lacking micronutrients in the ARFS population: niacin, Mg, K, P, Ca, Zn, B12, folate, Fe, and fiber. DISCUSSION: The ALASKA study protocol has been developed as a global strategy to manage and evaluate ARFS in Spanish adults older than 18 years of age. Approaching ARFS with multiple assessments, as influencing factors, will lead to a novel strategy for ARFS management. The FASSD has been designed as a personalized tool to avoid crucial micronutrient deficiencies that a current strict food allergen avoidance or elimination diet may provoke. TRIAL REGISTRATION: The protocol has been approved by the Ethics Committee of the UPM (REF.20200602) and registered on ClinicalTrials.gov (NCT05802017).

Physical condition and perceived fatigue in post-covid patients: An observational descriptive study.

BACKGROUND: Patients with severe coronavirus disease 2019 (COVID-19) often require hospital admission and experience sequelae such as chronic fatigue or low muscle mass. OBJECTIVE: To analyze the functional capacity of a cohort of patients with severe acute respiratory syndrome coronavirus 2 who required hospitalization. DESIGN AND SETTING: An observational descriptive study was conducted on post-COVID-19 patients referred to the Rehabilitation Department of Gregorio Marañón Hospital (Madrid, SPAIN). METHODS: Cardiorespiratory fitness, muscle strength, body composition, and perception of fatigue and dyspnea were analyzed. Furthermore, the existing correlations between clinical variables and physical conditions were analyzed. RESULTS: Forty-two patients who required hospital admission (80 ± 22.45 days) or intensive care unit (ICU) admission (58 ± 10.52 days) were analyzed. They presented with decreased strength, respiratory capacity, and moderate-to-severe perceived fatigue. Additionally, an inverse correlation was found between right-handgrip strength and days in the ICU, as well as the 6-minute walk test for women. Similarly, strength and fitness were negatively associated with perceived fatigue. CONCLUSIONS: Post-COVID-19 patients showed low muscle function and low levels of physical fitness associated with high perceived fatigue.

Design and validity of the Spanish version of two questionnaires related to adverse reactions to foodstuffs.

Introduction: Introduction: there is an emerging current necessity of valid questionnaires, encompassing most of food, beverages, diseases, signs and symptoms currently related to the pathogenesis of adverse reactions to foodstuffs (ARFS) in the Spanish population. Objectives: this study aimed to design and validate two questionnaires to assess ARFS in the Spanish population, Food and Beverages Frequency Consumption Questionnaire to Identify Adverse Reactions to Foodstuffs (FBFC-ARFSQ-18); and Pathologies and Symptomatology Questionnaire associated with Adverse Reactions to Foodstuffs (PSIMP-ARFSQ-10). Methods: both questionnaires were designed adapting questionnaires from the literature; and validated, using the expert judgment method, in five phases: questionnaires development, pilot test and reliability, content validity, face validity, and ethical considerations. Questionnaires were developed using the REDCap™ tool hosted at the Universidad Politécnica de Madrid. A total of 20 Spanish experts evaluated the questionnaires. Cronbach's alpha reliability coefficients were calculated using SPSS version 25.0 (IBM Corp., Armonk, NY-USA) and Aiken's V coefficient values were calculated using ICaiken.exe (Visual Basic 6.0, Lima-Perú). Results: a final construct of questions was designed, ensuring no overlap, for FBFC-ARFSQ-18 and PSIMP-ARFSQ-10. Cronbach's alpha reliability coefficients were 0.93 and 0.94; and Aiken's V coefficient values were 0.90 (0.78-0.96 CI) and 0.93 (0.81-0.98 CI) for FBFC-ARFSQ-18 and PSIMP-ARFSQ-10, respectively. Conclusions: both validated questionnaires could be used to analyze the association between certain food and beverages consumption with ARFS, such as food allergies and food intolerances; also, to investigate the link between some specific diseases, signs and symptoms with ARFS.

Introducción: Introducción: actualmente, existe una necesidad emergente de cuestionarios validados que abarquen la mayor parte de los alimentos, bebidas, enfermedades, signos y síntomas relacionados con la patogénesis de las reacciones adversas a los alimentos (RAA). Objetivos: diseñar y validar dos cuestionarios para evaluar las RAA en población española, el Cuestionario de Frecuencia de Consumo de Alimentos y Bebidas para Identificar Reacciones Adversas de Origen Alimentario (CFCAB-RAA-18); y el Cuestionario de Patologías y Sintomatología Asociadas a Reacciones Adversas a Alimentos (PSIMP-RAA-10). Métodos: ambos cuestionarios se diseñaron adaptando cuestionarios de la literatura y se validaron, utilizando el método de juicio de expertos, en cinco fases: desarrollo de cuestionarios, prueba piloto y confiabilidad, validez de contenido, validez aparente y consideraciones éticas. Los cuestionarios se desarrollaron utilizando la herramienta REDCap™. Un total de 20 expertos evaluaron los cuestionarios. Se calcularon coeficientes de confiabilidad alfa de Cronbach con SPSS versión 25.0 (IBM Corp., Armonk, NY-Estados Unidos) y valores del coeficiente V de Aiken con ICaiken.exe (Visual Basic 6.0, Lima-Perú). Resultados: se diseñó una construcción final de preguntas, evitando solapamiento entre ambas herramientas. Los coeficientes de confiabilidad alfa de Cronbach fueron 0,93 y 0,94, y los valores del coeficiente V de Aiken fueron 0,90 (IC: 0,78-0,96) y 0,93 (IC: 0,81-0,98) (CFCAB-RAA-18 y PSIMP-RAA-10, respectivamente). Conclusiones: ambos cuestionarios fueron validados y podrían utilizarse para analizar la asociación entre el consumo de determinados alimentos y bebidas con las RAA, como alergias e intolerancias alimentarias, así como para investigar el vínculo entre algunas enfermedades, signos y síntomas específicos con las RAA.

Ventilatory Threshold and Risk of Pulmonary Exacerbations in Cystic Fibrosis.

BACKGROUND: Whereas pulmonary exacerbations and aerobic fitness play a key role in the prognosis of cystic fibrosis (CF), the use of ventilatory threshold data as markers of exacerbation risk has been scarcely addressed. This study sought to examine the association between aerobic fitness, assessed through ventilatory threshold variables recorded during cardiopulmonary exercise testing (CPET), and the risk of exacerbations in individuals with CF. METHODS: Participants of this retrospective cohort study were subjects from 6 y of age. Over a 4-y period, the following data were recorded: lung function indicators, CPET variables, time to first exacerbation and antibiotic use, along with demographic, clinical, and anthropometric data. RESULTS: The mean age of 20 subjects included was 16 ± 5.4 y. Univariate regression analysis revealed that lung function (FEV1: Cox hazard ratio [HR] 0.97, P = .03; and forced expiratory flow between 25-75% of vital capacity [FEF25-75]: Cox HR 0.98, P = .036) and aerobic fitness (oxygen consumption [V̇O2 ] at ventilatory threshold: Cox HR 0.94, P = .01; and ventilatory equivalent for carbon dioxide [V̇E/V̇CO2 ] at ventilatory threshold: Cox HR 1.13, P = .049) were associated with exacerbation risk, whereas in the multivariate model, only V̇O2 at the ventilatory threshold (%max) (Cox HR 0.92, P = .01) had a significant impact on this risk. Consistently, individuals experiencing exacerbation had significantly lower V̇O2 values (%max) at the ventilatory threshold (P = .050) and higher ventilatory equivalent for oxygen consumption (V̇E/V̇O2 ) (P = .040) and V̇E/V̇O2 (P = .037) values at the ventilatory threshold. Time to exacerbation was significantly correlated with V̇O2 at the ventilatory threshold (r = 0.50, P = .02), V̇E/V̇O2 (r = -0.48, P = .02), and V̇E/V̇CO2 (r = -0.50, P = .02). CONCLUSIONS: Our results suggest an association between CPET variables at the ventilatory threshold and exacerbations. Percentage V̇O2 at the ventilatory threshold could serve as a complementary variable to monitor exacerbations in people with CF.