High-intensity interval training prevents muscle mass loss in overweight Chilean young adults during a hypocaloric-Mediterranean diet: a randomized trial.

The hypocaloric Mediterranean diet (MD) mainly reduces fat mass but inevitably causes a loss of skeletal muscle mass. High-intensity interval training (HIIT) seems to have advantages in preserving muscle mass during a hypocaloric regime. Our study compares body composition and metabolic changes in overweight and obese Chilean women and men after 3 months of weight loss treatment with a Mediterranean-type hypocaloric diet, HIIT, or a combination of both. The study included 83 overweight or obese women and men between the ages of 25 and 50. The subjects were randomly assigned to one of the three intervention groups: (1) MD, (2) EX, and (3) MD + EX. Baseline and post-intervention measurements included: (a) body composition by dual-beam densitometry, muscle, and fat measurements by thigh ultrasound and computed tomography; (b) handgrip and quadriceps muscle strength; (c) exercise performance by peak oxygen consumption, peak load, work efficiency, and exercise energy expenditure; and (d) metabolic parameters. Out of 83 participants, the retention rate was 49% due to low compliance with the interventions. As expected, the MD group resulted in significantly greater weight loss (MD -7%, EX -0.6% and MD + EX -5.3%) and appendicular fat mass loss (MD -11.1%, EX -2.9, MD + EX -10.2%) but was associated with significant lean tissue loss (2.8%), which was prevented by HIIT (EX -0.1 and MD + EX -0.6%). Metabolic and glycoxidative parameters remained unchanged, irrespective of changes in body composition. Hypocaloric diets remain the most effective means to lose weight and body fat. However, it induces a loss of lean body mass when not accompanied by exercise training. This study shows that HIIT prevents the loss of muscle mass caused by a hypocaloric Mediterranean diet.

Ajustando a RFR por Preditores de Discordância, "A RFR Ajustada": Uma Metodologia Alternativa para Melhorar a Capacidade Diagnóstica dos Índices Coronarianos / Adjusting RFR by Predictors of Disagreement, "The Adjusted RFR": An Alternative Methodology to Improve the Diagnostic Capacity of Coronary Indices

Resumo Fundamento Os limiares de corte para a "relação do ciclo completo de repouso" (RFR) oscilam em diferentes séries, sugerindo que as características da população podem influenciá-los. Da mesma forma, foram documentados preditores de discordância entre a RFR e a reserva de fluxo fracionado (FFR). O Estudo RECOPA, mostrou que a capacidade diagnóstica está reduzida na "zona cinzenta" da RFR, tornando necessária a realização de FFR para descartar ou confirmar isquemia. Objetivos Determinar os preditores de discordância, integrar as informações que eles fornecem em um índice clínico-fisiológico: a "RFR Ajustada", e comparar sua concordância com o FFR. Métodos Usando dados do Estudo RECOPA, os preditores de discordância em relação à FFR foram determinados na "zona cinzenta" da RFR (0,86 a 0,92) para construir um índice ("RFR Ajustada") que pesaria a RFR juntamente com os preditores de discordância e avaliar sua concordância com a FFR. Resultados Foram avaliadas 156 lesões em 141 pacientes. Os preditores de discordância foram: doença renal crônica, cardiopatia isquêmica prévia, lesões não envolvendo a artéria descendente anterior esquerda e síndrome coronariana aguda. Embora limitada, a "RFR Ajustada" melhorou a capacidade diagnóstica em comparação com a RFR na "zona cinzenta" (AUC-RFR = 0,651 versus AUC-"RFR Ajustada" = 0,749), mostrando também uma melhora em todos os índices diagnósticos quando foram estabelecidos limiares de corte otimizados (sensibilidade: 59% a 68%; especificidade: 62% a 75%; acurácia diagnóstica: 60% a 71%; razão de verossimilhança positiva: 1,51 a 2,34; razão de verossimilhança negativa: 0,64 a 0,37). Conclusões Ajustar a RFR integrando as informações fornecidas pelos preditores de discordância para obter a "RFR Ajustada" melhorou a capacidade diagnóstica em nossa população. Mais estudos são necessários para avaliar se os índices clínico-fisiológicos melhoram a capacidade diagnóstica da RFR ou de outros índices coronarianos.

Abstract Background Cutoff thresholds for the "resting full-cycle ratio" (RFR) oscillate in different series, suggesting that population characteristics may influence them. Likewise, predictors of discordance between the RFR and fractional flow reserve (FFR) have been documented. The RECOPA Study showed that diagnostic capacity is reduced in the RFR "grey zone", requiring the performance of FFR to rule out or confirm ischemia. Objectives To determine predictors of discordance, integrate the information they provide in a clinical-physiological index, the "Adjusted RFR", and compare its agreement with the FFR. Methods Using data from the RECOPA Study, predictors of discordance with respect to FFR were determined in the RFR "grey zone" (0.86 to 0.92) to construct an index ("Adjusted RFR") that would weigh RFR together with predictors of discordance and evaluate its agreement with FFR. Results A total of 156 lesions were evaluated in 141 patients. Predictors of discordance were: chronic kidney disease, previous ischemic heart disease, lesions not involving the anterior descending artery, and acute coronary syndrome. Though limited, the "Adjusted RFR" improved the diagnostic capacity compared to the RFR in the "grey zone" (AUC-RFR = 0.651 versus AUC-"Adjusted RFR" = 0.749), also showing an improvement in all diagnostic indices when optimal cutoff thresholds were established (sensitivity: 59% to 68%; specificity: 62% to 75%; diagnostic accuracy: 60% to 71%; positive likelihood ratio: 1.51 to 2.34; negative likelihood ratio: 0.64 to 0.37). Conclusions Adjusting the RFR by integrating the information provided by predictors of discordance to obtain the "Adjusted RFR" improved the diagnostic capacity in our population. Further studies are required to evaluate whether clinical-physiological indices improve the diagnostic capacity of RFR or other coronary indices.

Reproducibility and safety of the 30" sit to stand test in individuals with obesity and cardiovascular risk factors.

BACKGROUND: The 30″ sit to stand test is a submaximal exercise test that assesses functional capacity and it has been validated for various pathologies. Although it has been used in individuals with obesity, its reproducibility in this population has not yet been determined. The main objective of this study was to determine the reproducibility and safety of the 30″ sit to stand test in individuals with overweight or obesity and with cardiovascular risk factors. METHODS: A cross-sectional study was performed. Individuals with obesity or overweight who also presented cardiovascular risk factors were evaluated with the 30″ sit to stand test. The reproducibility and safety of the 30" sit to stand test were determined, as well as its association with other functional tests and anthropometric characteristics. RESULTS: 59 individuals (27 men, 32 women) with obesity or overweight and cardiovascular risk factors, aged 57.93 (9.62) years, were included in the study. The 30″ sit to stand test showed good overall reproducibility (0.907 ICC) and significant correlation with the 6-minute walk test, handgrip strength test, body fat percentage and waist - height index, with a similar hemodynamic response to the 6-minute walk test. CONCLUSION: The 30" sit to stand test is a highly reproducible and safe test for individuals with obesity and cardiovascular risk factors, with a significant correlation to anthropometric characteristics and other functional tests regularly used for the evaluation of individuals with obesity.

Adjusting RFR by Predictors of Disagreement, "The Adjusted RFR": An Alternative Methodology to Improve the Diagnostic Capacity of Coronary Indices. / Ajustando a RFR por Preditores de Discordância, "A RFR Ajustada": Uma Metodologia Alternativa para Melhorar a Capacidade Diagnóstica dos Índices Coronarianos.

BACKGROUND: Cutoff thresholds for the "resting full-cycle ratio" (RFR) oscillate in different series, suggesting that population characteristics may influence them. Likewise, predictors of discordance between the RFR and fractional flow reserve (FFR) have been documented. The RECOPA Study showed that diagnostic capacity is reduced in the RFR "grey zone", requiring the performance of FFR to rule out or confirm ischemia. OBJECTIVES: To determine predictors of discordance, integrate the information they provide in a clinical-physiological index, the "Adjusted RFR", and compare its agreement with the FFR. METHODS: Using data from the RECOPA Study, predictors of discordance with respect to FFR were determined in the RFR "grey zone" (0.86 to 0.92) to construct an index ("Adjusted RFR") that would weigh RFR together with predictors of discordance and evaluate its agreement with FFR. RESULTS: A total of 156 lesions were evaluated in 141 patients. Predictors of discordance were: chronic kidney disease, previous ischemic heart disease, lesions not involving the anterior descending artery, and acute coronary syndrome. Though limited, the "Adjusted RFR" improved the diagnostic capacity compared to the RFR in the "grey zone" (AUC-RFR = 0.651 versus AUC-"Adjusted RFR" = 0.749), also showing an improvement in all diagnostic indices when optimal cutoff thresholds were established (sensitivity: 59% to 68%; specificity: 62% to 75%; diagnostic accuracy: 60% to 71%; positive likelihood ratio: 1.51 to 2.34; negative likelihood ratio: 0.64 to 0.37). CONCLUSIONS: Adjusting the RFR by integrating the information provided by predictors of discordance to obtain the "Adjusted RFR" improved the diagnostic capacity in our population. Further studies are required to evaluate whether clinical-physiological indices improve the diagnostic capacity of RFR or other coronary indices.

FUNDAMENTO: Os limiares de corte para a "relação do ciclo completo de repouso" (RFR) oscilam em diferentes séries, sugerindo que as características da população podem influenciá-los. Da mesma forma, foram documentados preditores de discordância entre a RFR e a reserva de fluxo fracionado (FFR). O Estudo RECOPA, mostrou que a capacidade diagnóstica está reduzida na "zona cinzenta" da RFR, tornando necessária a realização de FFR para descartar ou confirmar isquemia. OBJETIVOS: Determinar os preditores de discordância, integrar as informações que eles fornecem em um índice clínico-fisiológico: a "RFR Ajustada", e comparar sua concordância com o FFR. MÉTODOS: Usando dados do Estudo RECOPA, os preditores de discordância em relação à FFR foram determinados na "zona cinzenta" da RFR (0,86 a 0,92) para construir um índice ("RFR Ajustada") que pesaria a RFR juntamente com os preditores de discordância e avaliar sua concordância com a FFR. RESULTADOS: Foram avaliadas 156 lesões em 141 pacientes. Os preditores de discordância foram: doença renal crônica, cardiopatia isquêmica prévia, lesões não envolvendo a artéria descendente anterior esquerda e síndrome coronariana aguda. Embora limitada, a "RFR Ajustada" melhorou a capacidade diagnóstica em comparação com a RFR na "zona cinzenta" (AUC-RFR = 0,651 versus AUC-"RFR Ajustada" = 0,749), mostrando também uma melhora em todos os índices diagnósticos quando foram estabelecidos limiares de corte otimizados (sensibilidade: 59% a 68%; especificidade: 62% a 75%; acurácia diagnóstica: 60% a 71%; razão de verossimilhança positiva: 1,51 a 2,34; razão de verossimilhança negativa: 0,64 a 0,37). CONCLUSÕES: Ajustar a RFR integrando as informações fornecidas pelos preditores de discordância para obter a "RFR Ajustada" melhorou a capacidade diagnóstica em nossa população. Mais estudos são necessários para avaliar se os índices clínico-fisiológicos melhoram a capacidade diagnóstica da RFR ou de outros índices coronarianos.

Predictive Psychosocial Factors of Child-to-Parent Violence in a Sample of Mexican Adolescents.

The aim of this study was to carry out a psychosocial analysis of child-to-parent violence (CPV) in a sample of school adolescents, considering a set of individual variables (psychological distress, problematic use of social networking sites, and perceived non-conformist social reputation) and family variables (open and problematic communication with parents) according to sex. The sample consisted of 3,731 adolescents (54% boys), aged between 14 and 16 years (M = 14.6 years, SD = 0.567), from the state of Nuevo León, Mexico. The scores of the boys and girls were analyzed to check for differences. Also, correlations between all the study variables were calculated. Finally, a multiple stepwise regression analysis was carried out for the total sample and also for boys and girls separately. Results confirmed the important role of individual variables as predictors of CPV in boys and girls. The main difference between boys and girls was observed in the predictive weight of problematic use of social networking sites, which was higher in girls than in boys. Open communication with the father was a significant factor for predicting the decrease of CPV levels in the case of boys, while open communication with the mother predicted the decrease of CPV in girls. Problematic communication with the mother showed similar values in boys and girls when predicting CPV, however, the predictive weight of problematic communication with the father was higher in girls than in boys. These results are interesting and have important implications for the prevention of CPV.

Predictive equations are inaccurate to assess caloric needs in non-white adults from Chile.

OBJECTIVES: Predictive equations are frequently used to estimate resting energy expenditure (REE) because indirect calorimetry (IC) is not always available and is expensive. The aim of this study was to determine the concordance between the estimation of REE using predictive equations and its measurement by IC. METHODS: This was an analysis of the registry of indirect calorimetry performed in non-hospitalized participants. Harris-Benedict, FAO/WHO/UNU, Mifflin St. Jeor, and European Society for Clinical Nutrition and Metabolism (ESPEN) equations were used to estimate REE in these individuals. The concordance between measured and estimated REE using real, ideal, and adjusted weight was calculated using the concordance coefficient analysis of Lin and Bland- Altman plots in all participants and in subgroups separated according to their body mass index. RESULTS: We retrieved 680 measurements and discarded 247 that did not comply with the inclusion criteria. Thus, we studied 433 participants ages 36 y (29-48 y). Of the participants, 341 were women (79%) and the participants had a body mass index (BMI) of 30 kg/m2 (26.7-33.1 kg/m2). All predictive equations had concordance values <0.90. The proportion of participants in which the difference was >10% ranged from 36% to 87%. The ESPEN equation had the greater proportion of erroneous estimations of REE in all participants and BMI subgroups when real weight was used. CONCLUSIONS: We observed a low level of concordance between REE estimated using predictive equations and measured by IC. These results should alert clinicians about the inaccuracy of predictive equations.

Association between activity energy expenditure and peak oxygen consumption with sarcopenia.

BACKGROUND: Sedentariness may be an important risk factor for sarcopenia. The aim of this work was to assess the association between muscle mass and strength and markers of usual physical activity such as activity energy expenditure and peak oxygen uptake. METHODS: Young and old participants were assessed measuring body composition by DEXA (double beam X ray absorptiometry), handgrip strength, peak oxygen consumption and workload during an exercise calorimetry in a braked cycle ergometer and a 72 h activity energy expenditure using Actiheart actigraphs. A heart rate/energy expenditure curve derived from the exercise calorimetry was used to calibrate each actigraph. Sarcopenia was defined as having an appendicular fat free mass index below 7.5 kg/m2 and 5.6 kg/m2 in men and women respectively, or a handgrip strength z score below 1, using local normal data or having both parameters below the cutoff points. RESULTS: We analyzed data from 192 assessments performed in participants aged 22 to 88 years (106 women). Sarcopenic participants (as determined by muscle mass, strength or both) had a significantly lower peak oxygen uptake and work load and a significantly lower activity energy expenditure. When analyzing lean mass and strength as continuous variables, peak oxygen consumption was a significant predictor of fat free mass in men. Among women, the association was observed only when percentage of muscle mass was expressed as a z score. CONCLUSIONS: Activity energy expenditure and peak oxygen consumption are associated with a lower muscle mass and the presence of sarcopenia and should be considered as risk factors for this condition.

Effects of Two Training Modalities on Body Fat and Insulin Resistance in Postmenopausal Women.

Henríquez, S, Monsalves-Alvarez, M, Jimenez, T, Barrera, G, Hirsch, S, de la Maza, MP, Leiva, L, Rodriguez, JM, Silva, C, and Bunout, D. Effects of two training modalities on body fat and insulin resistance in postmenopausal women. J Strength Cond Res 31(11): 2955-2964, 2017-Our objective was to compare the effects of a low-load circuit resistance training protocol and usual aerobic training in postmenopausal women. Postmenopausal women with at least 1 feature of the metabolic syndrome were randomly allocated to a low-load circuit resistance training protocol or traditional aerobic training in a braked cycle ergometer. The intervention consisted in supervised sessions lasting 40 minutes, 3 times per week, during 6 months. At baseline and at the end of the intervention, fasting serum lipid levels, serum interleukin 6, C-reactive protein, 8 isoprostanes, and insulin resistance (assessed through QUICKI and HOMA-IR) were measured. Body fat was measured by double-beam X-ray absorptiometry and by computed tomography densitometric quantification at lumbar 3 vertebral level. Twenty-one women aged 58 (54-59) years were allocated to aerobic training and 21 women aged 55 (52-61) years were allocated to the low-load circuit resistance training protocol. Eighteen and 16 women in each group completed the 6 months training period. Women in both groups experienced significant reductions in blood pressure, total body, subcutaneous, and intraabdominal body fat. Reductions in total cholesterol and triacylglycerol levels were also observed. No changes in insulin resistance indexes, 8 isoprostanes, C-reactive protein, or interleukin 6 were observed in either group. No significant differences between treatment groups were observed in any of the measured parameters. We conclude that low-load circuit resistance training and aerobic training resulted in the same reductions in body fat and serum lipid levels.

International trends in health science librarianship. Part 5 Latin America and the Caribbean.

This is the 5th in a series of articles exploring international trends in health science librarianship in Latin America and the Caribbean in the first decade of the 21st century. The invited authors are from Argentina, Bermuda and Mexico. Future issues will track trends in Central Europe and the Middle East. JM.

Comunicación familiar y comportamientos delictivos en adolescentes españoles: el doble rol mediador de la autoestima / Family communication and delinquent behavior among spanish adolescents: the mediating role of self-esteem

This research analyses the relationship among family communication (open communication versus communication problems), multidimensional self-esteem (family, academic, social and physical self-esteem) and behavioural problems in adolescence. Two independent samples were used in the study: Sample 1 was composed of 414 adolescents ranging in age from 12 to 17 years old, and Sample 2 was composed of 625 adolescents aged from 11 to 20 years old. Results showed an indirect effect of family communication on delinquent behavior through the mediation of self-esteem. We found a protection effect of family and academic self-esteem and a risk effect of social and physical self-esteem on delinquent behavior.

El presente estudio analiza las relaciones entre la comunicación familiar (comunicación abierta o problemática), la autoestima considerada desde una perspectiva multidimensional (autoestima familiar, escolar, social y física) y los comportamientos delictivos en adolescentes. Se utilizan dos muestras independientes: la primera está constituida por 414 chicas y chicos de 12 a 17 años y la segunda por 625 chicas y chicos de 11 a 20 años. Se observa, en las dos muestras, una influencia indirecta de la comunicación familiar en el comportamiento delictivo a través de una mediación de la autoestima. Además, se observa, tanto un efecto protector de las autoestimas familiar y escolar frente a la implicación en comportamientos delictivos, como un efecto de riesgo de las autoestimas social y física.

[Family functioning, self-esteem and substance use in adolescents: a mediational model]. / Funcionamiento familiar, autoestima y consumo de sustancias en adolescentes: un modelo de mediación.

OBJECTIVE: This research analyzes the direct and indirect relationships among family functioning, multidimensional self-esteem (family, academic, social, and physical self-esteem) and substance use. MATERIALS AND METHODS: The study participants were composed of two independent samples of Spanish adolescents who provided information during the 2003-2004 academic year (n1 = 414, Castilla and León; n2 = 625, Comunidad Valenciana). The statistical analyses were carried out using structural equation modelling and the procedure of mediation effects analysis (Holmbeck, 1997). RESULTS: Results showed a significant mediational effect of self-esteem on the relation between family functioning and adolescent substance use. Moreover, results showed, on the one hand, a protection effect of family and academic self-esteem in the face of substance use and, on the other hand, a risk effect of social and physical self-esteem. CONCLUSIONS: It is necessary to adopt a multidimensional perspective when analyzing the self-esteem of adolescents with substance use and to prevent the over-valuation of social and physical dimensions.

Funcionamiento familiar, autoestima y consumo de sustancias en adolescentes: un modelo de mediación / Family functioning, self-esteem and substance use in adolescents: a mediational model

OBJETIVO: Analizar las relaciones directas e indirectas entre el funcionamiento familiar, la autoestima considerada desde una perspectiva multidimensional (autoestima familiar, escolar, social y física) y el consumo de sustancias. MATERIAL Y MÉTODOS: Los datos se recogieron durante el año escolar 2003-2004 y corresponden a dos muestras independientes de adolescentes españoles (n1= 414, Castilla y León; n2= 625, Comunidad Valenciana). Para el análisis de datos se utilizó la técnica estadística de ecuaciones estructurales y se siguió el procedimiento de análisis de efectos mediadores de Holmbeck (1997). RESULTADOS: La autoestima media significativamente la influencia del funcionamiento familiar en el consumo de sustancias de los adolescentes. Además, se observa, por un lado, un efecto protector de las autoestimas familiar y escolar frente a la implicación en el consumo de sustancias y, por otro, un efecto de riesgo de las autoestimas social y física. CONCLUSIONES: Parece necesario adoptar una perspectiva multidimensional en el estudio de la autoestima de adolescentes consumidores y prevenir la sobrevaloración en las dimensiones social y física.

OBJECTIVE: This research analyzes the direct and indirect relationships among family functioning, multidimensional self-esteem (family, academic, social, and physical self-esteem) and substance use. MATERIALS AND METHODS: The study participants were composed of two independent samples of Spanish adolescents who provided information during the 2003-2004 academic year (n1= 414, Castilla & León; n2= 625, Comunidad Valenciana). The statistical analyses were carried out using structural equation modelling and the procedure of mediation effects analysis (Holmbeck, 1997). RESULTS: Results showed a significant mediational effect of self-esteem on the relation between family functioning and adolescent substance use. Moreover, results showed, on the one hand, a protection effect of family and academic self-esteem in the face of substance use and, on the other hand, a risk effect of social and physical self-esteem. CONCLUSIONS: It is necessary to adopt a multidimensional perspective when analyzing the self-esteem of adolescents with substance use and to prevent the over-valuation of social and physical dimensions.

Diagnóstico de la incompetencia cervical por ultrasonido / Ultrasonic diagnosis of cervical incompetence

Se analizaron 30 pacientes con datos anamnésicos y clínicos de incompetencia cervical; en 25 de ellas (83,3 %) se diagnosticó insuficiencia del orificio cervical interno. En nuestro trabajo catalogamos como de mal pronóstico el acortamiento del cuello. Debemos señalar que existen críterios en las bibliografías revisadas, acerca del valor del acortamiento del cuello para el pronóstico desfavorable. Los parámetros medidos en el estudio ultrasónico fueron: longitud del cuello, diámetro del canal cervical y estrechamiento del segmento inferior interno. Lo parámetros encontrados en nuestra casuística coinciden con la bibliografía. Por tratarse de un estudio prospectivo es necesario analizar la evolución de las gestantes para llegar a conclusiones definitivas

Analysis by fluorescence microscopy and flow cytometry of Monoclonal antibodies produced against cell surface antigens

La reactividad de siete anticuerpos monoclonales contra antígenos de superficie de las células de mieloma Sp2/O-Ag14 fue analizada simultáneamente por microscopía de fluorescencia y por citometría de flujo. Se incubaron 1 x 10**6 células de Sp2/O-Ag14 con 200 micronl de anticuerpo monoclonal a 4-C por 30 min. Luego de lavar 2 veces con PBS las células fueron incubadas a 4-C por 30 minutos con una dilución 1:400 de anticuerpos de carnero anti-immunoglobulinas de ratón, conjugados a isotiocianato de fluoresceína. Luego de lavar tres veces con PBS, las células se utilizaron para el análisis. Por microscoía de fluorescencia se detectaron diferentes patrones de reactividad con los anticuerpos monoclonales. Estos patrones fueron denominados: homogéneo anular, parchos anulares, parchos putiformes, difuso y homogéneo. Estos patrones podrían representar diferentes espítopes reconocidos monoclonales contra los antígenos de superficie de Sp2/O-Ag14 varió entre un 79 a un 90% al analizarse por cimetría de flujo con el sistema EPICS V. Al compararla con la microscopía de fluorescencia, la citometria de flujo determinó de una forma mas rápida, sensitiva y cuantitativa la reactividad de los diferentes anticuerpos monoclonales contra antígenos de superficie de las células Sp2/O-Ag14