Multidomain interventions for sarcopenia and cognitive flexibility in older adults for promoting healthy aging: a systematic review and meta-analysis of randomized controlled trials.

The global population is undergoing rapid aging, making physical activity a crucial element in preventing mortality and lowering the risk of Alzheimer's disease. Age-related declines in muscle mass and cognitive abilities significantly contribute to frailty and dependency. Thus, this study focuses on a meticulous analysis of the protective effects of multidomain interventions, an emerging resource combating age-related declines. It seeks to underscore their profound impact on cognitive flexibility and sarcopenia, highlighting their pivotal role in mitigating the adverse effects of aging. To identify relevant randomized controlled trials up to November 2023, we reviewed eight online academic databases, following PERSiST guidelines, PRISMA reporting system, and PICOs criteria. Meta-analyses on selected functional outcomes utilized a random-effects model, including the Timed Up and Go Test, Sit to Stand Test, Victoria Stroop Test, and Trail Making Test. Out of 2082 scrutinized articles, 17 were included in the systematic review, and 8 in the meta-analysis. Positive effects (p = 0.05, I2 = 57%; 95% CI - 0.63 to - 0.05) were observed in cognitive flexibility for certain interventions. Similarly, interventions addressing muscle strength demonstrated improvements in the Sit to Stand Test for the exercise group compared to the control group (p = 0.02, I2 = 0%; 95% CI - 0.63 to - 0.05). These findings underscore the importance of incorporating physical activity as a primary component of public health interventions for promoting healthy aging and reducing the burden of age-related diseases. Future interventions may explore more homogeneous approaches and evaluate the impact of thrice multidomain weekly sessions.

Resident physician duty hours, resting times and European Working Time Directive compliance in Spain: a cross-sectional study.

BACKGROUND: There is a growing interest in understanding the impact of duty hours and resting times on training outcomes and the well-being of resident physicians. However, to this date no state-wide analysis exists in any European country. OBJECTIVES: Our aim is to describe the shift work scheduling and to detail the degree of compliance with the Spanish legislation and the European Working Time Directive (EWTD) of Spanish resident physicians, focusing on territorial and specialty distribution. MATERIAL AND METHODS: A descriptive cross-sectional analytical study was designed through an online survey adapted from the existing literature. RESULTS: Out of the 2035 surveyed resident physicians undergoing PGT in Spain, 80.49% exceeded the 48 h per week limit set by the EWTD and 13% of them did not rest after a 24-h on-call shift. The mean number of on-call shifts in the last 3 months was 15.03, with the highest mean reported in Asturias, La Rioja, and Extremadura. 51.6% of respondents had a day-off after a Saturday on-call shift. Significant differences are observed by region and type of specialty. CONCLUSION: Resident physicians in Spain greatly exceed the established 48 h/week EWTD limit. Likewise, non-compliance with labor regulations regarding mandatory rest after on-call duty and minimum weekly rest periods are observed.

Medication related osteonecrosis of the jaws (MRONJ): Factors related to recurrence after treatment with surgery and platelet rich plasma (PRP) placement.

BACKGROUND: Medication-related osteonecrosis of the jaws (MRONJ) is a well-known complication associated with antiresorptive and antiangiogenic therapies. The purpose of this study was to analyse if there is any predictive factor of recurrence after local debridement plus platelet rich plasma (PRP) placement in MRONJ patients. MATERIAL AND METHODS: Seventy MRONJ patients treated at the department of Oral and Maxillofacial Surgery in La Paz Hospital (Madrid, Spain) were included in this retrospective study. All of them were treated surgically by local debridement and PRP placement. The observation period was between January 2012 and January 2019. Information regarding use, type, administration, and duration of therapy with BP/denosumab was recorded. The follow-up period ranged from 2-52 months. A descriptive analysis, a bivariate and a multivariate study were performed. RESULTS: Most of the patients were women (82.9%) between 50-70 years old (64.3%), with a stage II disease (74.3%). The therapy lasted more than 12 months in 54.8% of them. Zoledronic acid was the main antiresorptive used (44.3%), followed by oral administered BPs (29 patients, 41.4%) and denosumab (10 patients, 14.3%). Osteoporosis (48.6%), breast cancer (30%) and multiple myeloma (11.4%) were the main diseases because the patients were taking antirresorptives. 13 patients (18.6%) experienced recurrence. We found that breast cancer patients (p>0.0001), smokers (p>0.016), and administration of zoledronic acid (p>0.0001) were related to recurrence. After performing the multivariate model, we found that the only factor related to recurrence was smoking habit (Wald 3.837, p=0.05, OR 6.12). CONCLUSIONS: recurrence after local debridement plus PRP placement in our MRONJ series affected to 18.6% of patients. It seems to be more frequent in breast cancer patients, smokers, and after zoledronic acid administration. Smoking habit was the only independent factor related to recurrence in our series.

A 3-Case Series of Autoimmune Haemolytic Anaemia and COVID-19: Is Plasma Exchange an Alternative?

COVID-19 has rarely been associated with immune-mediated phenomena such as autoimmune haemolytic anaemia (AIHA). Both cold hemolysis with cold agglutinin detection and warm haemolysis have been described with variable prognoses. Current treatment regimens are based on experience with other case series and case reports, which still represent a clinical challenge. Corticosteroids, red cell transfusions and rituximab have been successfully employed. We present 3 cases of AIHA in the context of COVID-19 disease, the first case successfully treated with plasma exchange and long-term follow-up of the 3 cases showing complete remission of anaemia.

Associations between Physical Fitness, Bone Mass, and Structure in Older People.

The main aim was to analyse the associations between several physical fitness variables and bone parameters in a sample of elderly people. 129 participants (94 females and 35 males, 76.2 ± 5.4 y) from the EXERNET cohort of Zaragoza (Spain) were included in the study. Physical fitness was assessed using the Senior Fitness Test Battery. Peripheral quantitative computed tomography (pQCT) at the tibia and dual-energy X-ray absorptiometry (DXA) at the hip and lumbar spine were used to assess bone and muscle parameters. Partial correlations were used to describe the associations between fitness and bone parameters. A stepwise regression analysis was used to determine the influence of fitness variables on bone parameters. In males, significant correlations were found between lower body strength and agility with bone total mineral density (Tt.BMD) (r = 0.41 and -0.50) and cortical thickness (r = 0.40 and -0.50, respectively) and walking speed with total and cortical density (r = -0.41 and -0.40, respectively), all measured at tibia (all p < 0.05). Regarding DXA, neck areal bone mineral density (aBMD) correlated with flexibility (r = -0.37) and walking speed (r = 0.39) and Ward's triangle with walking speed (r = 0.39). Agility predicted Tt.BMD and cortical thickness (r 2 change = 24.8% and 23.0%), while walking speed predicted cortical bone mineral density (r 2 change = 19.5%) (all p < 0.05). Females showed correlations between balance and total hip aBMD (r = 0.27) and trochanter aBMD (r = 0.25). Balance predicted trochanter (r 2 change = 4.2%) and total hip aBMD (r 2 change = 4.9%) (both p < 0.05). In conclusion, bone mass in elderly males seems to be more influenced by physical fitness than in females, being agility and walking speed the variables showing greater associations. Other variables should be taken into account in females for future research.

Endothelial dysfunction is an early indicator of sepsis and neutrophil degranulation of septic shock in surgical patients.

BACKGROUND: Stratification of the severity of infection is currently based on the Sequential Organ Failure Assessment (SOFA) score, which is difficult to calculate outside the ICU. Biomarkers could help to stratify the severity of infection in surgical patients. METHODS: Levels of ten biomarkers indicating endothelial dysfunction, 22 indicating emergency granulopoiesis, and six denoting neutrophil degranulation were compared in three groups of patients in the first 12 h after diagnosis at three Spanish hospitals. RESULTS: There were 100 patients with infection, 95 with sepsis and 57 with septic shock. Seven biomarkers indicating endothelial dysfunction (mid-regional proadrenomedullin (MR-ProADM), syndecan 1, thrombomodulin, angiopoietin 2, endothelial cell-specific molecule 1, vascular cell adhesion molecule 1 and E-selectin) had stronger associations with sepsis than infection alone. MR-ProADM had the highest odds ratio (OR) in multivariable analysis (OR 11·53, 95 per cent c.i. 4·15 to 32·08; P = 0·006) and the best area under the curve (AUC) for detecting sepsis (0·86, 95 per cent c.i. 0·80 to 0·91; P < 0·001). In a comparison of sepsis with septic shock, two biomarkers of neutrophil degranulation, proteinase 3 (OR 8·09, 1·34 to 48·91; P = 0·028) and lipocalin 2 (OR 6·62, 2·47 to 17·77; P = 0·002), had the strongest association with septic shock, but lipocalin 2 exhibited the highest AUC (0·81, 0·73 to 0·90; P < 0·001). CONCLUSION: MR-ProADM and lipocalin 2 could be alternatives to the SOFA score in the detection of sepsis and septic shock respectively in surgical patients with infection.

ANTECEDENTES: La estratificación de la gravedad de una infección se basa actualmente en la puntuación SOFA (Sequential Organ Failure Assessment), que es difícil de calcular fuera de la unidad de cuidados intensivos. Los biomarcadores podrían ayudar a estratificar la gravedad de la infección en pacientes quirúrgicos. MÉTODOS: Se compararon las concentraciones de 10 biomarcadores que denotan disfunción endotelial, 22 que indican granulopoyesis de emergencia y 6 que expresan la degranulación de neutrófilos en tres grupos de pacientes de tres hospitales españoles (100 con infección, 95 con sepsis y 57 con shock séptico) en las primeras doce horas después del diagnóstico. RESULTADOS: Siete biomarcadores que expresan disfunción endotelial (proadrenomedulina, sindecan-1, trombomodulina, angiopoyetina-2, endocan-1, molécula de adhesión endotelial 1 y E-selectina) mostraron una fuerte asociación con la sepsis en comparación con la infección aislada. La proadrenomedulina presentó el valor más alto de la razón de oportunidades (odds ratio, OR) en el análisis multivariable (OR 11,53, i.c. del 95% 4,15-32,08, P = 0,006) y la mejor área bajo la curva para detectar sepsis (AUC 0,86, i.c. del 95% 0,80-0,91, P < 0,001). En la comparación entre sepsis y shock séptico, los biomarcadores que mostraron la asociación más estrecha con el shock séptico fueron dos biomarcadores de degranulación de neutrófilos (proteinasa-3 y lipocalina-2) (OR 8,09, i.c. del 9% 1,34-48,91, P = 0,028; OR 6.62, i.c. del 95% 2,47-17,77, P = 0,002), pero la lipocalina-2 presentó la mejor AUC (0,81, i.c. del 95% 0,73-0,90, P < 0,001). CONCLUSIÓN: la proadrenomedulina y la lipocalina-2 podrían representar alternativas a la puntuación SOFA para detectar sepsis y shock séptico en pacientes quirúrgicos con infección.

The muscle-bone unit in adolescent swimmers.

Most researchers adjust bone by lean mass when comparing swimmers with controls. This adjustment is done under the assumption that lean affects bone similarly in both groups. Nonetheless, we found that the muscle-bone association is uncoupled in swimmers, and consequently, researchers should avoid this adjustment when evaluating swimmers' bone. INTRODUCTION: To examine the functional and structural muscle-bone unit in adolescent swimmers. METHODS: Sixty-five swimmers (34 girls/31 boys) and 119 controls (51 girls/68 boys) participated in the study. Muscle cross-sectional area (MCSA), bone mineral content (BMC), and polar strength-strain index (SSIPOL) were measured in the non-dominant radius by peripheral quantitative computed tomography (pQCT). Subtotal BMC and lean mass were evaluated with dual-energy X-ray absorptiometry (DXA). Handgrip and isometric knee extension (IKE) tests were performed to determine muscle force. The effect of MCSA, lean and force on SSIPOL, and BMC were tested, and the functional and structural muscle-bone ratios of swimmers and controls were compared. RESULTS: Both muscle size (MCSA and lean) and muscle force (handgrip and IKE) influenced BMC and SSIPOL in swimmers and controls similarly. Swimmers presented normal MCSA and lean values for their height, but when compared with controls, swimmers presented a higher amount of lean and MCSA for the same BMC or SSIPOL (structural muscle-bone unit). For the functional muscle-bone unit, different results were found for the lower and upper limbs, as no differences were found for the upper limbs, while for the lower limbs, swimmers presented higher muscle force for the same amount of BMC. CONCLUSIONS: The contradictory results regarding BMC in swimmers found in previous studies could partly be explained with the findings of the present study that reinforce the idea that swimming is not an effective sport to practice regarding bone mass and that the muscle-bone unit is different in swimmers than in controls.

Do 6 months of whole-body vibration training improve lean mass and bone mass acquisition of adolescent swimmers?

Swimming has little effect on bone mass. Therefore, adolescent swimmers should complement their water training with a short and intense weight-bearing training, aiming to increase their bone acquisition. Forty swimmers performed a six-month whole-body vibration (WBV) training. WBV had no effect on adolescent swimmers' bone mass or lean mass. PURPOSE: The aims of the present study were to evaluate the effects of a whole-body vibration (WBV) intervention on bone mineral density (BMD), bone mineral content (BMC) and lean mass (LM) in adolescent swimmers. METHODS: Forty male and female adolescent swimmers (VIB; mean age 14.2 ± 1.9 years) completed the WBV protocol that consisted of 15 min of training 3 days per week during a 6-month period (ranging from 3.6 to 11.6 g), while 23 swimmers (SWI; mean age 15.0 ± 2.2 years) continued with their regular swimming training alone. VIB were divided into tertiles according to training compliance in order to evaluate if any dose-effect relation existed. BMD, BMC and LM were measured longitudinally by dual energy X-ray at the whole body, lumbar-spine and hip. RESULTS: No group by time interactions and no differences in change percentage were found for BMD, BMC or LM in any of the measured variables. The mean change percentage of the subtotal body (whole body minus the head) for VIB and SWI, respectively, was 2.3 vs. 2.4% for BMD, 5.7 vs 5.7% for BMC and 7.3 vs. 8.0% for lean mass. Moreover, no indication for dose-response was observed. CONCLUSIONS: The proposed WBV protocol had no effect on BMD, BMC and LM in adolescent swimmers. Other types of training should be used in this population to improve both bone and lean mass.

Stem cell-like transcriptional reprogramming mediates metastatic resistance to mTOR inhibition.

Inhibitors of the mechanistic target of rapamycin (mTOR) are currently used to treat advanced metastatic breast cancer. However, whether an aggressive phenotype is sustained through adaptation or resistance to mTOR inhibition remains unknown. Here, complementary studies in human tumors, cancer models and cell lines reveal transcriptional reprogramming that supports metastasis in response to mTOR inhibition. This cancer feature is driven by EVI1 and SOX9. EVI1 functionally cooperates with and positively regulates SOX9, and promotes the transcriptional upregulation of key mTOR pathway components (REHB and RAPTOR) and of lung metastasis mediators (FSCN1 and SPARC). The expression of EVI1 and SOX9 is associated with stem cell-like and metastasis signatures, and their depletion impairs the metastatic potential of breast cancer cells. These results establish the mechanistic link between resistance to mTOR inhibition and cancer metastatic potential, thus enhancing our understanding of mTOR targeting failure.

Swimming and bone: Is low bone mass due to hypogravity alone or does other physical activity influence it?

UNLABELLED: Swimming during adolescence has shown neutral or even negative effects on bone mass. Nevertheless, it is still unknown if these effects are due to swimming or to other factors, such as sedentary behaviors. INTRODUCTION: Three objectives were described (1) to measure objective physical activity (PA) additional to swimming performed by adolescent swimmers (SWI) and compare it to that performed by normo-active controls (CG), (2) to describe the relationship between objectively measured PA and bone mass, and (3) to compare bone mass of swimmers that meet the World Health Organization PA guidelines (active) WHO and those that do not (inactive). METHODS: A total of 71 SWI (33 females) and 41 CG (17 females) wore an accelerometer for at least 4 days. PA was expressed as the amount of time (minutes/day) in each intensity [sedentary/light/moderate or vigorous (VPA), and the sum of moderate and vigorous (MVPA)]. Using the cutoff points proposed by Vanhelst et al. SWI were classified as active or inactive according to whether they reached 60 min of weight-bearing MVPA per day or not. Bone mineral density (BMD) was measured by dual energy X-ray absorptiometry, and bone strength values were calculated with peripheral quantitative computed tomography. Differences in PA intensities were calculated between SWI and CG. The relation of VPA to bone mass was studied in the SWI. RESULTS: Male-SWI spend less time in VPA and MVPA than male-GC, which partly explains the lower BMD values in SWI than CG. CONCLUSION: Swimming may displace weight-bearing VPA with serious implications on bone health.

Bone structure of adolescent swimmers; a peripheral quantitative computed tomography (pQCT) study.

OBJECTIVES: The aims of the present study were: (1) to characterize vBMD, bone structure and strength with peripheral quantitative computerized tomography (pQCT) in adolescent swimmers and compare it to normo-active controls (CG); and (2) to evaluate the possible interaction that weight-bearing sports might have on swimmers bone. DESIGN: Cross-sectional. METHODS: The non-dominant radius and tibia of 79 (32 females) swimmers and 49 (22 females) CG (both 11-18 years old) were evaluated at proximal and distal sites with a pQCT scanner. Values of total, trabecular and cortical volumetric bone mineral density (vBMD) were obtained from each scan. Cortical thickness, endosteal and periosteal circumferences were also measured and bone strength indexes were calculated. Analyses of covariance were used to compare variables between groups adjusting for age, tanner stage and bone length. Three different analyses were performed according to present and past sport participation in addition to swimming in order to determine differences among swimmers who had performed or were performing other sports (OTHER-SP) (10 females/17 males) and swimmers who had not performed other sports (NO-OTHER-SP) (22 females/22 males). Both of these groups were compared to each other and to a CG (22 females/27 males). RESULTS: No differences were found between swimmers and CG for bone strength indexes, structure or vBMD (independently of the compared sample). CONCLUSIONS: These results indicate that swimmers present similar bone strength and structure than CG who did not present high physical activity levels.

Effect of whole-body vibration training on bone mass in adolescents with and without Down syndrome: a randomized controlled trial.

UNLABELLED: Whole-body vibration training (WBV) attracts great interest as osteoporosis prevention strategy. Twenty-six adolescents with and without Down syndrome (DS) (13 DS; 12-18 years) performed 20 weeks of WBV. The results indicate that WBV seems to provoke a lesser response in adolescents with DS than in those without DS. INTRODUCTION: This study aims to observe the differences between adolescents with and without DS in the effects of 20 weeks of WBV training, on bone mineral content (BMC) and density (BMD). METHODS: Twenty-six adolescents (13 DS; 12-18 years) were measured with dual-energy X-ray absorptiometry before and after the intervention (3/week, 10 repetitions (30-60 s) and 1-min rest, frequency 25-30 Hz and peak-to-peak displacement of 2 mm (peak acceleration 2.5-3.6 g)). Both, an intention-to-treat (ITT) analysis designed to assess the effects on bone mass and a per-protocol analysis, designed to compare poor and high compliers, were performed. RESULTS: The ITT analysis revealed significant increases in all BMC and BMD parameters (dz = 0.66 to 1.64; all p < 0.05) in the non-DS group, whilst DS group improved whole-body, subtotal (whole-body less head), upper limbs (ULIMBS), pelvis, lower limbs (LLIMBS) and spine BMC (dz = 0.75 to 1.76; all p < 0.05) and subtotal, pelvis, LLIMBS and spine BMD (dz = 0.73 to 1.28; all p < 0.05). Significantly greater increases were evident in the absolute and percent changes of the non-DS group over DS group (d = 0.88 to 3.85; all p < 0.05). ULIMBS BMD showed a tendency towards an interaction (f = 0.41 and p = 0.086) with higher increase for non-DS group. When a per-protocol analysis was considered, high-complier adolescents had 8.1 versus 5.3 % of gains in the spine BMC over poor-complier adolescents (d = 0.93; p < 0.05). CONCLUSIONS: Twenty weeks of WBV training may improve BMC and BMD in clinically relevant skeletal sites in both groups. Nevertheless, this type of training seems to provoke a lesser response in adolescents with DS than in those without DS.

Effect of whole body vibration training on bone mineral density and bone quality in adolescents with Down syndrome: a randomized controlled trial.

UNLABELLED: Adolescents with Down syndrome (DS) have poorer bone health than their peers without DS. Twenty-five adolescents with DS were randomly assigned to whole-body vibration training (WBV) or control groups. The results indicate that a 20-week WBV might be useful to improve subtotal bone mineral content and density in adolescents with DS. INTRODUCTION: This study aims to determine the effects of 20 weeks of whole body vibration training (WBV) on bone mineral content (BMC), density (BMD), and structure variables in adolescents with Down syndrome (DS). METHODS: This randomized controlled trial of 25 adolescents (12-18 years) with DS (8 females) generated 2 non-equal groups, WBV group (n = 11) and CON group (n = 14). Using an efficacy analysis, the primary outcomes were BMC and BMD by dual-energy X-ray absorptiometry and the secondary were bone structure variables by peripheral quantitative computed tomography. A synchronous vibration platform (PowerPlate®) was used (3/week, 10 repetitions (30-60 s) 1-min rest, frequency of 25-30 Hz, and peak-to-peak displacement of 2 mm (peak acceleration 2.5-3.6 g)). RESULTS: WBV group improved whole body BMC 2.8%, 95% CI [3.5, 2.1], subtotal area, BMC, and BMD by 2.8, 4.8, and 2%, respectively, 95% confidence intervals (CIs) [3.4, 2.1], [6.5, 3.1], and [2.8, 1.1], respectively (all, p < 0.05), showing group by time interactions in BMC and BMD (both p < 0.05). Lumbar spine BMC and BMD also increased in the WBV group by 6.6 and 3.3% both p < 0.05, 95 % CIs [8.6, 4.7], and [4.9, 1.7], respectively. Regarding bone structure, WBV group showed improvements in tibial BMC at 4 % (2.9 %, 95 % CI [3.0, 2.8]) and in volumetric BMD (vBMD), cortical vBMD, and cortical thickness at 66% of the radius (by 7.0, 2.4, and 10.9%; 95% CIs [7.4, 6.7], [2.6, 2.3], and [12.4, 9.3], respectively) (all, p < 0.05). CONCLUSIONS: A 20-week WBV, with this protocol, might be useful to improve subtotal BMC and BMD in adolescents with DS.

The effects of swimming training on bone tissue in adolescence.

The aim was to analyze bone mineral content (BMC) and density (BMD) in regular swimming trained adolescents and the interaction that weigh-bearing sports may have on these values. Bone mass was evaluated by dual energy x-ray absorptiometry (DXA) and quantitative ultrasound (QUS) in 77 swimmers (34 females/43 males) and 52 normoactive controls (CG; 23 females/29 males) from 11 to 18 years. Swimmers who had performed or were performing other sports (OSP; 11 females/20 males) were compared with pure swimmers (PSW; 23 females/23 males). Both groups were compared with CG. Bone values were compared using analyses of covariance adjusting for height, calcium intake, subtotal lean (whole body lean minus head), and pubertal status. Male PSW showed lower BMD and BMC at several sites than male CG. However, for male OSP, only lumbar spine BMC was lower in OSP than male CG. Male PSW showed lower BMD and BMC when compared with male OSP. Female PSW showed higher arm BMD and lower leg BMC than female CG, while female OSP only presented lower leg BMC than female CG. Contrary to males, female-PSW presented higher BMD and BMC than female OSP. No differences in QUS values were found between swimmers and CG. To summarize, although more information is needed for females, it seems that for males, swimming is associated with lower BMC and BMD.

Efectos del entrenamiento pliométrico sobre la resistencia cardiorrespiratoria de niños y adolescentes con síndrome de Down / Effects of a circuit training including plyometric jumps on cardiorespiratory fitness of children and adolescents with Down syndrome

Objetivo: Determinar los efectos de 21 semanas de entrenamiento en circuito, incluyendo saltos pliométricos sobre la resistencia cardiorrespiratoria de jóvenes con síndrome de Down (SD). Método: Veintisiete jóvenes con SD de entre 10 y 19 años participaron en este estudio. Los participantes se dividieron en dos grupos: ejercicio (EJE; n= 14) y control (CON; n=13). Antes y después de la realización del programa de entrenamiento se midieron los siguientes parámetros: tiempo de trabajo, valores máximos de consumo de oxígeno, cociente respiratorio, frecuencia cardíaca y ventilación minuto de los participantes mediante una prueba de esfuerzo progresiva en tapiz rodante. Resultados: Los participantes del grupo EJE aumentaron todos los parámetros cardiovasculares en comparación con su valor basal, después del entrenamiento (todos p< 0,05). Además, a pesar de tener unos valores similares antes del entrenamiento, el grupo EJE mostró valores más elevados que el grupo CON después del entrenamiento (todos p<0,05). Conclusión: Se puede concluir que los jóvenes con síndrome de Down pueden conseguir mejoras en diversos parámetros cardiorrespiratorios tras la ejecución de 21 semanas de entrenamiento con ejercicios pliométricos (AU)

Aim: To ascertain the effects of 21 weeks of circuit training, including plyometric jumps, on cardiorespiratory fitness of youths with Down’s syndrome (DS). Methods: Twenty-seven children and adolescent aged 10 to 19 years with DS participated in this study and were divided in two groups: exercise (EXE, n=14) and control (CON, n=13). Work time, peak values of oxygen consumption, respiratory exchange ratio, heart rate and minute ventilation of the participants were measured pre- and post-training with a graded exercise treadmill test. Results: EXE group increased all their cardiorespiratory parameters compared to baseline after 21 weeks of training (all P<.05). Additionally, and despite having similar pre-training values, the EXE group showed higher values than the CON group in all cardiorespiratory parameters after training (all P<.05). Conclusion: It may be concluded that youths with Down syndrome can achieve improvements in several cardiorespiratory parameters when performing 21 weeks of training including plyometric exercises (AU)

Do calcium and vitamin D intake influence the effect of cycling on bone mass through adolescence? / ¿Influye la ingesta de calcio y vitamina D en el efecto del ciclismo sobre la masa ósea durante la adolescencia?

INTRODUCTION: Cycling has been associated with decreased bone mass during adolescence. Calcium (Ca) and vitamin D (VitD) intake are associated to bone mass and may be important confounders when studying bone mass.AIM: To clarify the effect that Ca and VitD may have on bone mass in adolescent cyclists. METHODS: Bone mineral content (BMC) and density (BMD) of 39 male adolescents (20 cyclists) were measured. Ca and VitD intake were also registered. Different ANCOVA analyses were performed in order to evaluate the influence of Ca and VitD on BMC and BMD. RESULTS: Cyclists showed lower values of BMC and BMD than controls at several sites and when adjusting by Ca, Wards triangle BMD appeared also to be lower in cyclists than controls. CONCLUSION: Nutritional aspects might partially explain differences regarding bone mass in adolescent cyclists and should be taken into account inbone mass analysis as important confounders (AU)

Introducción: El ciclismo se ha asociado con un descenso de la masa ósea durante la adolescencia. La ingesta de calcio (Ca) y vitamina D (VitD) repercute sobre la masa ósea llegando a ser factores de confusión importantes al estudiarla. Objetivo: Clarificar el efecto que el Ca y la VitD pueden tener sobre la masa ósea de ciclistas adolescentes. Métodos: se midió el contenido mineral óseo (CMO) y la densidad mineral ósea (DMO) de 39 varones adolescentes (20 ciclistas). También se registró la ingesta de Ca y VitD. Se realizaron distintos análisis ANCOVA para evaluar la influencia del Ca y la VitD sobre el CMO y la DMO. Resultados: Los ciclistas mostraron menores valores de CMO y DMO que los controles en diversas zonas y, cuando se ajustó por Ca, la DMO del triángulo de Wards también pasó a ser menor en los ciclistas que en los controles. Conclusión: Los aspectos nutricionales podrían explicar en parte las diferencias de masa ósea en ciclistas adolescentes y deberían tenerse en cuenta en el análisis de masa ósea como factores de confusión importantes (AU)

Physical activity and cardiorespiratory fitness in adolescents with Down syndrome / Actividad física y estado de forma cardiovascular en adolescentes con síndrome de down

AIMS: To determine if adolescents with and without Down syndrome (DS) accomplish the physical activity (PA) guidelines and to evaluate relationships between PA and cardiorespiratory variables.METHODS:42 adolescents (27 with DS) participated in this study. PA was measured using accelerometers. Walking-graded treadmill protocol with a breath-by-breath gas analyzer was employed to assess cardiorespiratory fitness. RESULTS: Adolescents with DS spent less time in sedentary PA, moderate PA (MPA), vigorous PA (VPA) and moderate to vigorous PA (MVPA) than those without DS. VO2peak was correlated with total minutes spent in light PA, MPA, VPA and MVPA in the control group (from r = 0.55 to r = 0.61, p < 0.05) and with MPA and MVPA in the DS group (from r = 0.38 to r = 0.41, p < 0.05). CONCLUSION: Nor DS neither control groups achieved at least 60 minutes of MPA daily. Engaging more time in MPA was associated with greatercardiorespiratory fitness in adolescents with DS (AU)

Objetivos: Comprobar si los adolescentes con síndrome de Down (SD) cumplen las guías de actividad física (AF) y evaluar la relación entre AF y la condición cardiorrespiratoria. Métodos: 42 adolescentes (27 con SD) participaron en este estudio. La AF se midió usando acelerometría. La condición cardiorrespiratoria se evaluó mediante ergoespirometría en tapiz rodante con un protocolo progresivo continuo. Resultados: Los adolescentes con SD pasaron menos tiempo en AF sedentaria, moderada (MAF), vigorosa (VAF) y moderada-vigorosa (MVAF) que los adolescentes sin SD. El VO2peak mostró correlación con minutos totales en AF ligera, MAF, VAF y MVAF en el grupo control (desde r = 0,55 hasta r = 0,61, p < 0,05) y con MAF y VAF en el grupo de adolescentes con SD (desde r = 0,38 hasta r = 0,41, p < 0,05). Conclusión: Ningún grupo alcanzó 60 minutos de MAF diaria. La capacidad cardiorrespiratoria en adolescentes con SD se asoció con una mayor participación en MAF (AU)

The nutritional status in adolescent Spanish cyclists / Estado nutritivo de ciclistas adolescentes españoles

INTRODUCTION: Adolescence is an important period of nutritional vulnerability due to the increased dietary requirements. Objective: To describe the nutritional status of adolescent cyclist and a group of normoactive controls. METHODS: The HELENA Dietary Assessment Tool was used to evaluate the nutritional intake of 20 adolescent cyclists and 17 controls. Total energy intake, resting energy expenditure (REE), total energy expenditure (TEE), macronutrients and several micronutrients were registered and compared with dietary guidelines. RESULTS: REE was lower and TEE higher in cyclists than in controls (both P < 0.01). Significant differences were observed in phosphorus and vitamin B1 being higher in cyclists (P < 0.05). Most participants, both cyclist and controls, did not reach the diet requirements for macronutrients, vitamins and minerals. CONCLUSION: Nutritional status of adolescent cyclists and controls seems not to fulfil the requirements in quantity and quality. Possible implications for actual and future health especially in athlete adolescents need further research (AU)

Introducción: La adolescencia es un periodo importante de vulnerabilidad nutricional dados las mayores demandas alimentarias. Objetivo: Describir el estado nutritivo de ciclistas adolescentes y de un grupo de controles con actividad normal. Métodos: Se utilizó la Herramienta de Evaluación Alimentaria HELENA para evaluar la ingesta nutricional de 20 ciclistas adolescentes y 17 controles. Se registraron la ingesta total de energía, el gasto de energía en reposo (GER), el gasto de energía total (GET), los macronutrientes y diversos micronutrientes y se compararon con las guías dietéticas. Resultados: El GER fue menor y el GTE mayor en los ciclistas que en los controles (ambos P < 0,01). Se observaron diferencias significativas en el fósforo y la vitamina B1, siendo mayores en los ciclistas (P < 0,05). La mayor parte de los participantes, tanto ciclistas como controles, no alcanzó los requerimientos en macronutrientes, vitaminas ni minerales. Conclusión: El estado nutritivo de los adolescentes ciclistas y de los controles parece no adecuarse a las recomendaciones de cantidad y calidad. Deberían investigarse las posibles implicaciones de la salud actual y futura, especialmente en los adolescentes atletas (AU)

Do calcium and vitamin D intake influence the effect of cycling on bone mass through adolescence?

INTRODUCTION: Cycling has been associated with decreased bone mass during adolescence. Calcium (Ca) and vitamin D (VitD) intake are associated to bone mass and may be important confounders when studying bone mass. AIM: To clarify the effect that Ca and VitD may have on bone mass in adolescent cyclists. METHODS: Bone mineral content (BMC) and density (BMD) of 39 male adolescents (20 cyclists) were measured. Ca and VitD intake were also registered. Different ANCOVA analyses were performed in order to evaluate the influence of Ca and VitD on BMC and BMD. RESULTS: Cyclists showed lower values of BMC and BMD than controls at several sites and when adjusting by Ca, Wards triangle BMD appeared also to be lower in cyclists than controls. CONCLUSION: Nutritional aspects might partially explain differences regarding bone mass in adolescent cyclists and should be taken into account in bone mass analysis as important confounders.

Introducción: El ciclismo se ha asociado con un descenso de la masa ósea durante la adolescencia. La ingesta de calcio (Ca) y vitamina D (VitD) repercute sobre la masa ósea llegando a ser factores de confusión importantes al estudiarla. Objetivo: Clarificar el efecto que el Ca y la VitD pueden tener sobre la masa ósea de ciclistas adolescentes. Métodos: se midió el contenido mineral óseo (CMO) y la densidad mineral ósea (DMO) de 39 varones adolescentes (20 ciclistas). También se registró la ingesta de Ca y VitD. Se realizaron distintos análisis ANCOVA para evaluar la influencia del Ca y la VitD sobre el CMO y la DMO. Resultados: Los ciclistas mostraron menores valores de CMO y DMO que los controles en diversas zonas y, cuando se ajustó por Ca, la DMO del triángulo de Wards también pasó a ser menor en los ciclistas que en los controles. Conclusión: Los aspectos nutricionales podrían explicar en parte las diferencias de masa ósea en ciclistas adolescentes y deberían tenerse en cuenta en el análisis de masa ósea como factores de confusión importantes.