Concerns about the application of resistance exercise with blood-flow restriction and thrombosis risk in hemodialysis patients.

BACKGROUND: Hemodialysis (HD) per se is a risk factor for thrombosis. Considering the growing body of evidence on blood-flow restriction (BFR) exercise in HD patients, identification of possible risk factors related to the prothrombotic agent D-dimer is required for the safety and feasibility of this training model. The aim of the present study was to identify risk factors associated with higher D-dimer levels and to determine the acute effect of resistance exercise (RE) with BFR on this molecule. METHODS: Two hundred and six HD patients volunteered for this study (all with a glomerular filtration rate of <15 mL/min/1.73 m2). The RE + BFR session consisted of 50% arterial occlusion pressure during 50 min sessions of HD (intradialytic exercise). RE repetitions included concentric and eccentric lifting phases (each lasting 2 s) and were supervised by a strength and conditioning specialist. RESULTS: Several variables were associated with elevated levels of D-dimer, including higher blood glucose, citrate use, recent cardiovascular events, recent intercurrents, higher inflammatory status, catheter as vascular access, older patients (>70 years old), and HD vintage. Furthermore, RE + BFR significantly increases D-dimer after 4 h. Patients with borderline baseline D-dimer levels (400-490 ng/mL) displayed increased risk of elevating D-dimer over the normal range (≥500 ng/mL). CONCLUSION: These results identified factors associated with a heightened prothrombotic state and may assist in the screening process for HD patients who wish to undergo RE + BFR. D-dimer and/or other fibrinolysis factors should be assessed at baseline and throughout the protocol as a precautionary measure to maximize safety during RE + BFR.

Geriatric and Gerontology Research: A Scientometric Investigation of Open Access Journal Articles Indexed in the Scopus Database.

BACKGROUND: Scientometric analyses of specific topics in geriatrics and gerontology have grown robustly in scientific literature. However, analyses using holistic and interdisciplinary approaches are scarce in this field of research. This article aimed to demonstrate research trends and provide an overview of bibliometric information on publications related to geriatrics and gerontology. METHODS: We identified relevant articles on geriatrics and gerontology using the search terms "geriatrics," "gerontology," "older people," and "elderly." VOSviewer was used to perform bibliometric analysis. RESULTS: A total of 858 analyzed articles were published in 340 journals. Among the 10 most contributory journals, five were in the United States, with the top journal being the Journal of the American Geriatrics Society. The United States was the leading country in research, followed by Japan, Canada, and the United Kingdom. A total of 5,278 keywords were analyzed. In the analysis of research hotspots, the main global research topics in geriatrics and gerontology were older adults (n=663), education and training (n=471), and adults aged 80 years (n=461). These were gradually expanded to include areas related to caring for older adults, such as geriatric assessments (n=395). CONCLUSION: These results provide direction for fellow researchers to conduct studies in geriatrics and gerontology. In addition, they provide government departments with guidance for formulating and implementing policies that affect older adults, not only in setting academic and professional priorities but also in understanding key topics related to them.

Effects of resistance training on hepcidin levels and iron bioavailability in older individuals with end-stage renal disease: A randomized controlled trial.

Anemia is an inherent complication of older individuals with end-stage renal disease (ESRD) that is associated with inflammation which in turn is an important factor in the activation of hepcidin that contributes to the decrease in serum iron. Athough resistance training (RT) seems to reduce inflammation in ESRD, its influence on hepcidin and iron availability in hemodialysis patients is unclear. Therefore, the aim of this study was to exemine the effects of RT in on inflammatory profile, hepcidin, and iron status in older individuals with ESRD. End-stage renal disease patients (N: 157, age: 66.8 ± 3.6; body mass: 73 ± 15 body mass index:27 ± 3), were assigned to control (CTL n: 76) and exercise groups (RT n: 81). RT consisted of 24 weeks/3 days per week of a moderate intensity. There was an increase in the bioavailability of iron (ΔRT: 22.2; ΔCTL: -1 µg/dL, p < 0.0001), a decrease in hepcidin levels (ΔRT: -7.9; ΔCTL: 0.2 ng/mL, p < 0.0001),and an improvement of the inflammatory profile. These novel findings show that RT is a potential coadjuvant to reduce iron deficiency by decreasing the levels of hepcidin and pro-inflammatory markers in older patients undergoing hemodialysis.

Efeitos de 16 semanas de exercícios multimodais na capacidade funcional e cognitiva em idosos / Effects of 16 weeks of multimodal exercise on functional and cognitive capacity in the elderly / Efectos de 16 semanas de ejercicios multimodales sobre la capacidad funcional y cognitiva de los ancianos

O presente estudo buscou verificar o efeito de 16 semanas de exercícios multimodais na capacidade funcional e cognitiva em idosos comunitários do município de Tocantinópolis-TO. A pesquisa teve caráter descritivo, longitudinal e quase- experimental. Participaram deste estudo 44 idosos, sendo 20 do sexo masculino, com média de idade de 69 ± 7,3 anos e 24 do sexo feminino, com média de idade de 66 ± 7,6 anos. A seleção dos participantes foi realizada por meio da técnica de amostragem por conveniência em utentes da Academia da Melhor Idade (AMI), em Tocantinópolis-TO. Antes e após as 16 semanas de intervenção com exercícios multimodais, foram aplicadas: a bateria Senior fitness test de Rikli & Jones (2013) e avaliação do estado cognitivo com o Mini Exame de Estado Mental (MEEM). Em relação às variáveis da capacidade funcional, apenas o teste de "Caminhada de 6 minutos" apresentou diferença significativa nos participantes do sexo masculino (C6Min pré = 516,2 metros vs. pós = 545,8 metros; p < 0,05). Nas mulheres foram observadas diferenças significativas nas variáveis "Levantar e Sentar da Cadeira" (LSC pré = 12,5 repetições vs. Pós = 14,1 repetições; p < 0,05), "Sentado, Caminhar 2,44 m e sentar" (SCS pré = 7,3 segundos vs. pós = 6,8 segundos; p < 0,05) e "Caminhada de 6 minutos" (C6Min pré = 483,1 m vs. pós = 514,1 m; p < 0,05). O nível de cognição apresentou diferença significativa após 16 semanas de intervenção em relação aos valores verificados no baseline, tanto para os homens (MEEM pré = 21,2 vs. pós = 23,9; p < 0,05), quanto para as mulheres (MEEM pré = 23,9 pontos vs. pós = 25,1 pontos; p < 0,05). Conclui-se que os exercícios multimodais foram efetivos na melhora da cognição em e em determinadas variáveis relacionadas à capacidade funcional nos idosos após 16 semanas de intervenção.

The present study sought to verify the effect of 16 weeks of multimodal exercises on functional and cognitive capacity in community elderly of the municipality of Tocantinópolis-TO. The research had a descriptive, longitudinal and quasi- experimental character. This study included 44 elderly subjects, 20 of whom were male, with mean age of 69 ± 7.3 years, and 24 of whom were female, with mean age of 66 ± 7.6 years. The selection of the participants was carried out by means of the technique of sampling for convenience in users of the Academy of the Best Age (AMI), in Tocantinópolis-TO. Before and after the 16 weeks of intervention with multimodal exercises, we applied: the Rikli & Jones Senior fitness test (2013) and cognitive status assessment with the Mini Mental State Examination (MEEM). Regarding the functional capacity variables, only the "6-minute walk" test showed a significant difference in the male participants (C6Min pre = 516.2 meters vs. post = 545.8 meters; p < 0.05). In women, significant differences were observed in the variables "Lift and Sit of the Chair" (LSC pre = 12.5 repetitions vs. Post = 14.1 repetitions; p < 0.05), "Sit, Walk 2.44 m and sit" (SCS pre = 7.3 seconds vs. post = 6.8 seconds; p < 0.05) and "Walk of 6 minutes" (C6Min pre = 483.1 m vs. post = 514.1 m; p < 0.05). The level of cognition was significantly different after 16 weeks of intervention from baseline values for both men (pre-MSE = 21.2 vs. post = 23.9; p < 0.05) and women (pre-MSE = 23.9 points vs. post = 25.1 points; p < 0.05). It is concluded that multimodal exercises were effective in improving cognition in and in certain variables related to functional capacity in the elderly after 16 weeks of intervention.

Este estudio buscó verificar el efecto de 16 semanas de ejercicio multimodal sobre la capacidad funcional y cognitiva de las personas mayores en el municipio de Tocantinópolis-TO. La investigación tenía un carácter descriptivo, longitudinal y casi experimental. Este estudio incluyó 44 sujetos de edad avanzada, 20 de los cuales eran hombres, de una edad media de 69 ± 7,3 años y 24 eran mujeres, con una edad media de 66 ± 7,6 años. La selección de los participantes se realizó mediante una técnica de muestreo para la conveniencia de los usuarios de la Academia de la Mejor Edad (AMI), en Tocantinópolis-TO. Antes y después de 16 semanas de intervención con ejercicios multimodales, se aplicó la Senior fitness test de Rikli & Jones (2013) y la evaluación del estado cognitivo con el Mini Examen de Estado Mental (MEEM). Para las variables de capacidad funcional, sólo el test de "caminata de 6 minutos" mostró una diferencia significativa en los participantes masculinos (C6Min pre = 516,2 metros vs. post = 545,8 metros; p < 0,05). En las mujeres se observaron diferencias significativas en las variables "Levantamiento y siéntate desde la silla" (pre = 12,5 repeticiones vs. Post = 14,1 repeticiones; p < 0,05), "Sitting, Walk 2,44 m y Sit" (pre-SCS = 7,3 segundos vs. Post = 6,8 segundos; p < 0,05) y "6 minutos de sentido" (C6S) Mínimo pre = 483,1 m vs. post = 514,1 m; p < 0,05). El nivel de cognición fue significativamente diferente después de 16 semanas de intervención respecto al valor baseline para ambos hombres (MEEM pre= 21,2 vs. post = 23,9; p < 0,05) y mujeres (MEEM pre= 23,9 puntos vs. post = 25,1 puntos; p < 0,05). Se concluye que los ejercicios multimodales fueron eficaces para mejorar la cognición en y sobre determinadas variables relacionadas con la capacidad funcional en las personas mayores después de 16 semanas de intervención.