Relationship between Femur Mineral Content and Local Muscle Strength and Mass.

Among the stimuli able to prevent early decreases in bone mineralization, exercise has a noticeable role per se as the source of mechanical stimulus or through lean tissue enlargement by its increasing of tensional stimulus. However, prevention strategies, including exercise, generally do not establish the moment in life when attention should begin to be paid to bone integrity, according to age group- and sex-related differences. Thus, this study analyzed the relationship between variables from the diagnosis of total and regional body composition, muscle strength, and bone mineral content (BMC) of femurs in young adult males. Thirty-four young Caucasian men (24.9 ± 8.6 years) had their body composition and bone density assessed by dual X-ray absorptiometry. The subjects performed a one-repetition maximum test (1-RM) in a bench press, front pulley, seated-row, push press, arm curl, triceps pulley, leg flexion, leg extension, and 45° leg press for the assessment of muscle strength in upper and lower limbs in single- and multi-joint exercises. Lean tissue mass in the trunk and upper and lower limbs were related to femoral BMC (Pearson coefficient ranging from 0.55 to 0.72, p < 0.01), and 1-RM values for different exercises involving both upper and lower limbs also correlated with femoral BMC (Pearson coefficients ranging from 0.34 to 0.46, p < 0.05). Taken together, these correlations suggest that muscle mass and strength are positively linked with the magnitude of femoral mass in men, even in early adulthood. Hence, the importance of an enhanced muscle mass and strength to the health of femoral bones in young adults was highlighted.

Comparing Video Analysis to Computerized Detection of Limb Position for the Diagnosis of Movement Control during Back Squat Exercise with Overload.

Incorrect limb position while lifting heavy weights might compromise athlete success during weightlifting performance, similar to the way that it increases the risk of muscle injuries during resistance exercises, regardless of the individual's level of experience. However, practitioners might not have the necessary background knowledge for self-supervision of limb position and adjustment of the lifting position when improper movement occurs. Therefore, the computerized analysis of movement patterns might assist people in detecting changes in limb position during exercises with different loads or enhance the analysis of an observer with expertise in weightlifting exercises. In this study, hidden Markov models (HMMs) were employed to automate the detection of joint position and barbell trajectory during back squat exercises. Ten volunteers performed three lift movements each with a 0, 50, and 75% load based on body weight. A smartphone was used to record the movements in the sagittal plane, providing information for the analysis of variance and identifying significant position changes by video analysis (p < 0.05). Data from individuals performing the same movements with no added weight load were used to train the HMMs to identify changes in the pattern. A comparison of HMMs and human experts revealed between 40% and 90% agreement, indicating the reliability of HMMs for identifying changes in the control of movements with added weight load. In addition, the results highlighted that HMMs can detect changes imperceptible to the human visual analysis.

Stroke and physiological relationships during the incremental front crawl test: outcomes for planning and pacing aerobic training.

Purpose: This study aimed to evaluate the physiological responses associated with the stroke length (SL) and stroke rate (SR) changes as swimming velocity increases during an incremental step-test. Moreover, this study also aimed to verify if SL and SR relationships toward maximal oxygen uptake (V̇O2max), gas respiratory compensation point (RCP), exchange threshold (GET), and swimming cost can be applied to the management of endurance training and control aerobic pace. Methods: A total of 19 swimmers performed the incremental test until volitional exhaustion, with each stage being designed by percentages of the 400 m (%v400) maximal front crawl velocity. V̇O2max, GET, RCP, and the respective swimming velocities (v) were examined. Also, the stroke parameters, SL, SR, the corresponding slopes (SLslope and SRslope), and the crossing point (Cp) between them were determined. Results: GET and RCP corresponded to 70.6% and 82.4% of V̇O2max (4185.3 ± 686.1 mL min-1), and V̇O2 at Cp, SLslope, and SRslope were observed at 129.7%, 75.3%, and 61.7% of V̇O2max, respectively. The swimming cost from the expected V̇O2 at vSLslope (0.85 ± 0.18 kJ m-1), vSRslope (0.77 ± 0.17 kJ m-1), and vCp (1.09 ± 0.19 kJ m-1) showed correlations with GET (r = 0.73, 0.57, and 0.59, respectively), but only the cost at vSLslope and vCp correlated to RCP (0.62 and 0.69) and V̇O2max (0.70 and 0.79). Conclusion: SL and SR exhibited a distinctive pattern for the V̇O2 response as swimming velocity increased. Furthermore, the influence of SL on GET, RCP, and V̇O2max suggests that SLslope serves as the metabolic reference of heavy exercise intensity, beyond which the stroke profile defines an exercise zone with high cost, which is recommended for an anaerobic threshold and aerobic power training. In turn, the observed difference between V̇O2 at SRslope and GET suggests that the range of velocities between SL and SR slopes ensures an economical pace, which might be recommended to develop long-term endurance. The results also highlighted that the swimming intensity paced at Cp would impose a high anaerobic demand, as it is located above the maximal aerobic velocity. Therefore, SLslope and SRslope are suitable indexes of submaximal to maximal aerobic paces, while Cp's meaning still requires further evidence.

Effects of Exercise and Sports Intervention and the Involvement Level on the Mineral Health of Different Bone Sites in the Leg, Hip, and Spine: A Systematic Review and Meta-Analysis.

The current study analysed whether the osteogenic stimuli of exercises and sports have an independent effect on bone mineral density (BMD). Studies with a design having two different cohorts were searched and selected to distinguish the effect due to long-term involvement (i.e., athletes vs. non-active young with good bone health) and due to the planning of intervention (i.e., pre- vs. post-training) with exercises and sports. Moreover, only studies investigating the bone sites with a body-weight support function (i.e., lower limb, hip, and spine regions) were reviewed, since the osteogenic effects have incongruous results. A meta-analysis was performed following the recommendations of PRISMA. Heterogeneity (I2) was determined by combining Cochran's Q test with the Higgins test, with a significance level of α = 0.05. The studies reporting the effect of involvement in exercise and sports showed high heterogeneity for the lower limb, total hip, and spine (I2 = 90.200%, 93.334%, and 95.168%, respectively, with p < 0.01) and the effect size on sports modalities (Hedge's g = 1.529, 1.652, and 0.417, respectively, with p < 0.05) ranging from moderate to high. In turn, the studies reporting the effect of the intervention planning showed that there was no heterogeneity for the lower limb (I2 = 0.000%, p = 0.999) and spine (I2 = 77.863%, p = 0.000); however, for the hip, it was moderate (I2 = 49.432%, p = 0.054), with a low effect between the pre- and post-training moments presented only for the hip and spine (Hedge's g = 0.313 and 0.353, respectively, with p < 0.05). The current analysis supported the effect of involvement in exercise and sports by evidencing the effect of either weight-bearing or non-weight-bearing movements on BMD at the femoral, pelvic, and lumbar bones sites of the athletes when comparing to non-athletes or non-active peers with healthy bones. Moreover, the effect of different exercise and sports interventions highlighted the alterations in the BMD in the spine bone sites, mainly with long-term protocols (~12 months) planned with a stimulus with high muscle tension. Therefore, exercise and sport (mainly systematic long-term practice) have the potential to increase the BMD of bones with body-weight support beyond the healthy values reached during life phases of youth and adulthood.

Oxygen Uptake Kinetics and Time Limit at Maximal Aerobic Workload in Tethered Swimming.

This study aimed to apply an incremental tethered swimming test (ITT) with workloads (WL) based on individual rates of front crawl mean tethered force (Fmean) for the identification of the upper boundary of heavy exercise (by means of respiratory compensation point, RCP), and therefore to describe oxygen uptake kinetics (VO2k) and time limit (tLim) responses to WL corresponding to peak oxygen uptake (WLVO2peak). Sixteen swimmers of both sexes (17.6 ± 3.8 years old, 175.8 ± 9.2 cm, and 68.5 ± 10.6 kg) performed the ITT until exhaustion, attached to a weight-bearing pulley-rope system for the measurements of gas exchange threshold (GET), RCP, and VO2peak. The WL was increased by 5% from 30 to 70% of Fmean at every minute, with Fmean being measured by a load cell attached to the swimmers during an all-out 30 s front crawl bout. The pulmonary gas exchange was sampled breath by breath, and the mathematical description of VO2k used a first-order exponential with time delay (TD) on the average of two rest-to-work transitions at WLVO2peak. The mean VO2peak approached 50.2 ± 6.2 mL·kg-1·min-1 and GET and RCP attained (respectively) 67.4 ± 7.3% and 87.4 ± 3.4% VO2peak. The average tLim was 329.5 ± 63.6 s for both sexes, and all swimmers attained VO2peak (100.4 ± 3.8%) when considering the primary response of VO2 (A1' = 91.8 ± 6.7%VO2peak) associated with the VO2 slow component (SC) of 10.7 ± 6.7% of end-exercise VO2, with time constants of 24.4 ± 9.8 s for A1' and 149.3 ± 29.1 s for SC. Negative correlations were observed for tLim to VO2peak, WLVO2peak, GET, RCP, and EEVO2 (r = -0.55, -0.59, -0.58, -0.53, and -0.50). Thus, the VO2k during tethered swimming at WLVO2peak reproduced the physiological responses corresponding to a severe domain. The findings also demonstrated that tLim was inversely related to aerobic conditioning indexes and to the ability to adjust oxidative metabolism to match target VO2 demand during exercise.

Effects of exercise training on glucocorticoid-induced muscle atrophy: Literature review.

Glucocorticoids (GCs) administration, such as cortisol acetate (CA) and dexamethasone (DEXA), is used worldwide due to their anti-inflammatory, anti-allergic, and immunosuppressive properties. However, muscle atrophy is one of the primary deleterious induced responses from the chronic treatment with GCs since it stimulates muscle degradation inhibiting muscle protein synthesis. Animal models allow a better understanding of the molecular pathways involved in this process of gene modulation and production of hypertrophic and atrophic proteins. The treatment with GCs, such as DEXA, promotes the reduction of hypertrophic proteins such as serine/threonine tyrosine kinase (AKT), protein kinase mammalian target of rapamycin (mTOR), and ribosomal protein S6 kinase (p70S6K) and increased gene expression or production of atrophic proteins, such as myostatin, muscle atrophic F-box (atrogin-1), or muscle ring finger protein-1 (MuRF-1). In both continuous exercise (CE) and resistance exercise (RE) forms, exercise training is used to mitigate muscle atrophy induced by GCs. The CE attenuated muscle atrophy induced by CA or DEXA in the plantaris and extensor digitorum longus muscles, while RE mitigated the DEXA-induced atrophy in plantaris and flexor hallucis longus muscles. The RE response appears to have occurred by modulation of hypertrophic proteins through increased protein production or phosphorylated/total ratio of mTOR and p70S6K and decreased atrophic protein production of MuRF-1. CE needs future research to understand the molecular pathways of its protective response.

Training methods for maximal static apnea performance: a systematic review and meta-analysis.

INTRODUCTION: Currently, there is an increase in people practicing freediving (FD) both in competition and leisure. As a sports practice, its modalities are grouped into static, dynamic, and constant weight apnea. The aim of this systematic review and meta-analysis (PROSPERO-CRD42021230322) was to identify the training methods used to improve the static apnea time (AT) performance. EVIDENCE ACQUISITION: Ten training protocols were analyzed from eight studies published until March 09, 2022. The effect size (Hedge's g) and its confidence interval (CI95%) were calculated from the AT measured pre- and post-training. EVIDENCE SYNTHESIS: Three different apnea training methods were verified, the breath-hold (BH) that uses BH exercises, physical training with strength and cardiorespiratory exercises, and cross training that combines BH exercises with physical training. These training methods were applied to 138 participants of both sexes with or without experience in apnea episode or diving practice. In general, the AT improvement showed a large effect after the interventions (g=1.30, CI95%=0.85-1.76, P<0.01). CONCLUSIONS: All three methods were effective in improving static AT, however from the existing protocols is not possible to recommend an ideal to improve AT and therefore FD performance.

The effect of the exercise environment and the level of involvement on bone mineral health.

INTRODUCTION: This study aimed to compare athletes practicing exercise in different environments with non-active young and elderly men and women regarding bone mineral density (BMD), hypothesizing that BMD values differ between athletes according to the environment of exercise practice, but those training in a low-gravitational environment have no different stimuli to BMD increasing if compared with healthy peers experiencing reduced exercise involvement, whatever the age group and sex. MATERIALS AND METHODS: 104 participants of both sexes were selected according to the environment of exercise practice [swimmers (N = 26) and judo fighters (N = 26)], and exercise level of involvement [non-active young (N = 26) and older adults (N = 26)]. Dual-energy X-ray absorptiometry provided BMD, lean mass, and fat mass (FM) for the whole body (WB), upper (UL), and lower limbs (LL). RESULTS: For the BMD in WB, UL and LL no effects of group and sex were observed (p > 0.05). Post-hoc analyses detected higher values of BMD in UL for female swimmers compared to non-active older adults (p < 0.05), while judo fighters showed higher BMD in WB, UL, and LL than other participants whatever the sex (p < 0.01). Lower FM was observed for WB, UL, and LL when swimmers and judo fighters were compared to non-active young and older female peers (p < 0.01). CONCLUSION: The findings emphasized that BMD stimuli with swimming are reduced when compared to judo, and despite the stimuli in swimming is not distinguishable from that affecting BMD in WB, UL and LL of non-active young, it is effective in differing BMD in UL among non-active older for women.

Time limit and V̇O2 kinetics at maximal aerobic velocity: Continuous vs. intermittent swimming trials.

The time sustained during exercise with oxygen uptake (V̇O2) reaching maximal rates (V̇O2peak) or near peak responses (i.e., above second ventilatory threshold [t@VT2) or 90% V̇O2peak (t@90%V̇O2peak)] is recognized as the training pace required to enhance aerobic power and exercise tolerance in the severe domain (time-limit, tLim). This study compared physiological and performance indexes during continuous and intermittent trials at maximal aerobic velocity (MAV) to analyze each exercise schedule, supporting their roles in conditioning planning. Twenty-two well-trained swimmers completed a discontinuous incremental step-test for V̇O2peak, VT2, and MAV assessments. Two other tests were performed in randomized order, to compare continuous (CT) vs. intermittent trials (IT100) at MAV until exhaustion, to determine peak oxygen uptake (Peak-V̇O2) and V̇O2 kinetics (V̇O2K). Distance and time variables were registered to determine the tLim, t@VT2, and t@90%V̇O2peak tests. Blood lactate concentration ([La-]) was analyzed, and rate of perceived exertion (RPE) was recorded. The tests were conducted using a breath-by-breath apparatus connected to a snorkel for pulmonary gas sampling, with pacing controlled by an underwater visual pacer. V̇O2peak (55.2 ± 5.6 ml·kg·min-1) was only reached in CT (100.7 ± 3.1 %V̇O2peak). In addition, high V̇O2 values were reached at IT100 (96.4 ± 4.2 %V̇O2peak). V̇O2peak was highly correlated with Peak-V̇O2 during CT (r = 0.95, p < 0.01) and IT100 (r = 0.91, p < 0.01). Compared with CT, the IT100 presented significantly higher values for tLim (1,013.6 ± 496.6 vs. 256.2 ± 60.3 s), distance (1,277.3 ± 638.1 vs. 315.9 ± 63.3 m), t@VT2 (448.1 ± 211.1 vs. 144.1 ± 78.8 s), and t@90%V̇O2peak (321.9 ± 208.7 vs. 127.5 ± 77.1 s). V̇O2K time constants (IT100: 25.9 ± 9.4 vs. CT: 26.5 ± 7.5 s) were correlated between tests (r = 0.76, p < 0.01). Between CT and IT100, tLim were not related, and RPE (8.9 ± 0.9 vs. 9.4 ± 0.8) and [La-] (7.8 ± 2.7 vs. 7.8 ± 2.8 mmol·l-1) did not differ between tests. MAV is suitable for planning swimming intensities requiring V̇O2peak rates, whatever the exercise schedule (continuous or intermittent). Therefore, the results suggest IT100 as a preferable training schedule rather than the CT for aerobic capacity training since IT100 presented a significantly higher tLim, t@VT2, and t@90%V̇O2peak (∼757, ∼304, and ∼194 s more, respectively), without differing regards to [La-] and RPE. The V̇O2K seemed not to influence tLim and times spent near V̇O2peak in both workout modes.

The Effect of Resistance Training on Bone Mineral Density in Older Adults: A Systematic Review and Meta-Analysis.

Resistance training (RT) has been considered an intervention with effective stimulus on bone mineral formation and is, therefore, recommended to decrease the rate of bone morpho-functional proprieties loss with aging. Thus, this meta-analysis aimed to analyze the effectiveness of RT protocols in promoting changes in bone mineral density (BMD) in older adults. The systematic reviews and meta-analysis followed the PRISMA guidelines (PROSPERO CRD42020170859). The searches were performed in the electronic databases using descriptors according to the PICO strategy. The methodological quality and risk of bias were assessed with the PEDro scale, and the magnitude of the results was determined by Hedges' g. Seven studies involving 370 elderlies, with the RT planned as a unique exercise mode of intervention, showed designs with four to five exercises for upper- and lower-limbs musculature, two to three sets per exercise, eight to twelve repetitions to failure at 70-90% 1 RM, 60-120 s of rest between sets, and executed three times per week for 12-52 weeks. The RT protocols were classified between good and excellent and evidenced a positive effect on the BMD at the hip (0.64%) and spine (0.62%) but not in the femoral neck (-0.22%) regardless of the intervention length. The narrow range of either positive or negative changes in the BMD after the RT intervention support, at best, a preventive effect against the increasing risk of bone frailty in an older population, which is evident beyond 12 weeks of RT practice engagement.

Single- and Multi-Joint Maximum Weight Lifting Relationship to Free-Fat Mass in Different Exercises for Upper- and Lower-Limbs in Well-Trained Male Young Adults.

This study aimed to analyze whether the relationship between regional and whole-body fat-free mass (FFM) and strength is related to FFM distribution and area according to limb involvement. Thirty well-trained male young adults underwent one-repetition maximum test (1RM) to assess the strength in arm curl (AC), bench press (BP), seated row (SR), leg press 45° (LP45), knee extension (KE), and leg curl (LC). Dual-energy X-ray absorptiometry was used to evaluate FFM. The values for 1RM in AC, BP, and R correlated to FFM in upper limb (R2 = 0.69, 0.84 and 0.75), without an effect of appendicular mass index (API) or area. For 1RM in KE, the correlation with FFM in lower limb increased with thigh area (R2 = 0.56), whereas 1RM in LC and LP45 correlation to whole-body FFM increased with API (R2 = 0.64 and 0.49). The upper limb's FFM may be reliable for indexing the arms and upper trunk strengths, whereas the relationships between FFM and strength in lower limb improve as muscle mass and thigh area increases between subjects.

Are Young Swimmers Short and Middle Distances Energy Cost Sex-Specific?

This study assessed the energy cost in swimming (C) during short and middle distances to analyze the sex-specific responses of C during supramaximal velocity and whether body composition account to the expected differences. Twenty-six swimmers (13 men and 13 women: 16.7 ± 1.9 vs. 15.5 ± 2.8 years old and 70.8 ± 10.6 vs. 55.9 ± 7.0 kg of weight) performed maximal front crawl swimming trials in 50, 100, and 200 m. The oxygen uptake ( V ˙ O2) was analyzed along with the tests (and post-exercise) through a portable gas analyser connected to a respiratory snorkel. Blood samples were collected before and after exercise (at the 1st, 3rd, 5th, and 7th min) to determine blood lactate concentration [La-]. The lean mass of the trunk (LM Trunk ), upper limb (LM UL ), and lower limb (LM LL ) was assessed using dual X-ray energy absorptiometry. Anaerobic energy demand was calculated from the phosphagen and glycolytic components, with the first corresponding to the fast component of the V ˙ O2 bi-exponential recovery phase and the second from the 2.72 ml × kg-1 equivalent for each 1.0 mmol × L-1 [La-] variation above the baseline value. The aerobic demand was obtained from the integral value of the V ˙ O2 vs. swimming time curve. The C was estimated by the rate between total energy releasing (in Joules) and swimming velocity. The sex effect on C for each swimming trial was verified by the two-way ANOVA (Bonferroni post hoc test) and the relationships between LM Trunk , LM UL , and LM LL to C were tested by Pearson coefficient. The C was higher for men than women in 50 (1.8 ± 0.3 vs. 1.3 ± 0.3 kJ × m-1), 100 (1.4 ± 0.1 vs. 1.0 ± 0.2 kJ × m-1), and 200 m (1.0 ± 0.2 vs. 0.8 ± 0.1 kJ × m-1) with p < 0.01 for all comparisons. In addition, C differed between distances for each sex (p < 0.01). The regional LM Trunk (26.5 ± 3.6 vs. 20.1 ± 2.6 kg), LM UL (6.8 ± 1.0 vs. 4.3 ± 0.8 kg), and LM LL (20.4 ± 2.6 vs. 13.6 ± 2.5 kg) for men vs. women were significantly correlated to C in 50 (R 2 adj = 0.73), 100 (R 2 adj = 0.61), and 200 m (R 2 adj = 0.60, p < 0.01). Therefore, the increase in C with distance is higher for men than women and is determined by the lean mass in trunk and upper and lower limbs independent of the differences in body composition between sexes.

Comparative study of strategies to prevent esophageal and periesophageal injury during atrial fibrillation ablation.

OBJECTIVE: To compare the prevalence of esophageal and periesophageal thermal injury in patients undergoing radiofrequency (RF) atrial fibrillation (AF) ablation using 8 mm tip catheters during three different esophageal protection strategies. METHODS: Forty-five consecutive patients with paroxysmal or persistent AF underwent first ablation procedure, besides esophagogastroduodenoscopy (EGD) combined with radial endosonography (EUS) performed before and after the pulmonary vein (PV) isolation. Before the procedure, patients were randomly assigned to one of three esophageal lesion protection strategies: group I-without any protective or monitoring dispositive and limiting RF applications to 30 W for 20 seconds, in left atrium posterior wall (LAPW); group II-power and time of RF delivery, up to 50 W for 20 seconds at LAPW, limited by esophageal temperature monitoring; group III-applications of RF in LAPW with fixed power application of 50 W for 20 seconds during continuous esophageal cooling. RESULTS: Baseline characteristics of patients were similar in all groups. The four PVs were isolated in 14 (93.3%), 13 (86.7%), and 15 (100%) patients, respectively in groups I, II, and III. The mean RF power was significantly higher (P < .001) in the posterior side of PVs in group III. Post-AF ablation EGD and EUS revealed two esophageal wall ulcerations and two periesophageal mediastinal edemas only in the esophageal cooling group (P = .008). CONCLUSION: Esophageal cooling balloon strategy resulted in a higher RF power energy delivery when ablating at the LA posterior wall, using 8 mm nonirrigated tip catheters under temperature mode control. Despite that, patients presented a relatively low incidence of esophageal and periesophaeal injuries.

Suction versus slow-pull for endoscopic ultrasound-guided fine-needle aspiration of pancreatic tumors: a prospective randomized trial.

BACKGROUND: Suction (S) is commonly used to improve cell acquisition during endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). Slow-pull (SP) sampling is another technique that might procure good quality specimens with less bloodiness. We aimed to determine if SP improves the diagnostic yield of EUS-FNA of pancreatic masses. METHODS: Patients with pancreatic solid masses were randomized to four needle passes with both techniques in an alternate fashion. Sensitivity, specificity, positive, and negative predictive values were calculated. Cellularity and bloodiness of cytological samples were assessed and compared according to the technique. RESULTS: Sensitivity, specificity, and accuracy of suction vs. SP were 95.2% vs. 92.3%; 100% vs. 100; 95.7% vs. 93%, respectively. As to the association of methods, they were 95.6, 100 and 96%, respectively. Positive predictive values for S and SP were 100%. There was no difference in diagnostic yield between S and SP (p = 0.344). Cellularity of samples obtained with SP and Suction were equivalent in both smear evaluation (p = 0.119) and cell-block (0.980). Bloodiness of SP and suction techniques were similar as well. CONCLUSIONS: S and SP techniques provide equivalent sensitivity, specificity, and accuracy. Association of methods seems to improve diagnostic yield. Suction does not increase the bloodiness of samples compared to slow-pull.

LED session prior incremental step test enhance VO2max in running.

This study aimed to investigate the effect of prior LED sessions on the responses of cardiorespiratory parameters during the running incremental step test. Twenty-six healthy, physically active, young men, aged between 20 and 30 years, took part in this study. Participants performed two incremental load tests after placebo (PLA) and light-emitting diode application (LED), and had their gas exchange, heart rate (HR), blood lactate, and rating of perceived exertion (RPE) monitored during all tests. The PLA and LED conditions were compared using the dependent Student t test with significance set at 5%. The T test showed higher maximum oxygen uptake (VO2max) (PLA = 47.2 ± 5.7; LED = 48.0 ± 5.4 ml kg-1 min-1, trivial effect size), peak velocity (Vpeak) (PLA = 13.4 ± 1.2; LED = 13.6 ± 1.2 km h-1, trivial effect size), and lower maximum HR (PLA = 195.3 ± 3.4; LED = 193.3 ± 3.9 b min-1, moderate effect size) for LED compared to PLA conditions. Furthermore, submaximal values of HR and RPE were lower, and submaximal VO2 values were higher when LED sessions prior to the incremental step test were applied. A positive response of the previous LED application in the blood lactate disappearance was also demonstrated, especially 13 and 15 min after the test. It is concluded that LED sessions prior to exercise modify cardiorespiratory response by affecting running tolerance during the incremental step test, metabolite clearance, and RPE. Therefore, LED could be used as a prior exercise strategy to modulate oxidative response acutely in targeted muscle and enhance exercise tolerance.

Primary adenosquamous cell carcinoma of the pancreas: the use of endoscopic ultrasound guided - fine needle aspiration to establish a definitive cytologic diagnosis / Carcinoma adenoescamoso primario de páncreas: uso de la técnica de biopsia por aspiración con aguja fina guiada por ultrasonido endoscópico para establecer un diagnóstico citológico definitivo

Pancreatic cancer is the second most common malignancy of the gastrointestinal tract in the US, and adenocarcinoma has been identified as the most common type of pancreatic cancer. Different types of pancreatic cancers have been classified: adenocarcinoma, ductal adenosquamous carcinoma, solid pseudopapillary tumors, endocrine neoplasms, acinar cell carcinoma, squamous cell carcinoma, cystic tumors, primary lymphoma of the pancreas, and metastatic lesions of the pancreas. Adenosquamous carcinoma is extremely rare, behave in a very aggressive way and is responsible for the 1 to 4% of the pancreatic exocrine neoplastic lesions. We describe the case of an 82-years-old African American female, presenting to our institution with quantifiable weight loss (12 kg in 3 months), jaundice and abdominal pain. On admission, laboratory tests were obtained: total bilirubin: 11.07 mg/dl with a direct fraction of 10.32 mg/dl. Cross-sectional abdominal CT scan with contrast, showed a lesion localized in the pancreatic head (hypodense on T1, measuring 3.5 x 3.5 x 2.5 cm), with vascular invasion of the portal vein. EUS showed a solid, hypoechoic, not well-defined lesion (measuring 3.98 x 3.80 cm), localized between the head and neck of the pancreas. EUS-FNA was performed with a 22G needle using the fanning technique. The cytological specimens demonstrated components of both squamous carcinoma and adenocarcinoma. The patient underwent ERCP procedure, and biliary drainage was performed with an entirely covered metallic stent placement. After a month from the procedures, the patient died due to the severity of the disease. Endoscopic ultrasound has proven to be the best method to diagnose solid pancreatic lesions, including rare and aggressive type of tumors like primary adenosquamous cell carcinoma that we described in this very interesting case report

El cáncer de páncreas es la segunda neoplasia maligna más común del tracto gastrointestinal en los EE.UU. y el adenocarcinoma ha sido identificado como el tipo más común de cáncer de páncreas. Se han clasificado diferentes tipos de cáncer de páncreas: adenocarcinoma, carcinoma adenoescamoso ductal, tumores pseudopapilares sólidos, neoplasias endocrinas, carcinoma de células acinares, carcinoma de células escamosas, tumores quísticos, linfoma primario del páncreas y lesiones metastásicas del páncreas. El carcinoma adenoescamoso es extremadamente raro y se comporta de manera muy agresiva, es responsable del 1 al 4% de las lesiones pancreáticas exocrinas neoplásicas. Presentamos el caso de una mujer afroamericana de 82 años de edad, que fue admitida a nuestra institución con pérdida de peso cuantificable (12 kg en 3 meses), ictericia y dolor abdominal. Al momento de la admisión, se obtuvieron pruebas de laboratorio: bilirrubina total: 11,07 mg/dl con una fracción directa de 10,32 mg/dl. La tomografía computarizada abdominal transversal con contraste mostró una lesión localizada en la cabeza pancreática (hipodensa en T1, 5 x 3,5 x 2,5 cm) con invasión vascular de la vena porta. El ultrasonido endoscópico mostró una lesión sólida, hipoecoica, no bien definida de 3,98 x 3,80 cm, localizada entre la cabeza y el cuello del páncreas. La biopsia por aspiración con aguja fina guiada por ultrasonido endoscópico se realizó con una aguja 22G utilizando la técnica de ventilación (Fanning). Los especímenes citológicos demostraron componentes de carcinoma escamoso y adenocarcinoma. El paciente se sometió a CPRE y el drenaje biliar se realizó con una prótesis metálica completamente cubierta. Después de un mes de los procedimientos, el paciente falleció debido a la gravedad de la enfermedad. El ultrasonido endoscópico ha demostrado ser el mejor método para diagnosticar lesiones pancreáticas sólidas, incluyendo tumores raros y agresivos como el carcinoma primario de células adenoescamosas que describimos en este interesante relato de caso

A Rapidly-Incremented Tethered-Swimming test for Defining Domain-Specific Training Zones.

The purpose of this study was to investigate whether a tethered-swimming incremental test comprising small increases in resistive force applied every 60 seconds could delineate the isocapnic region during rapidly-incremented exercise. Sixteen competitive swimmers (male, n = 11; female, n = 5) performed: (a) a test to determine highest force during 30 seconds of all-out tethered swimming (Favg) and the ΔF, which represented the difference between Favg and the force required to maintain body alignment (Fbase), and (b) an incremental test beginning with 60 seconds of tethered swimming against a load that exceeded Fbase by 30% of ΔF followed by increments of 5% of ΔF every 60 seconds. This incremental test was continued until the limit of tolerance with pulmonary gas exchange (rates of oxygen uptake and carbon dioxide production) and ventilatory (rate of minute ventilation) data collected breath by breath. These data were subsequently analyzed to determine whether two breakpoints defining the isocapnic region (i.e., gas exchange threshold and respiratory compensation point) were present. We also determined the peak rate of O2 uptake and exercise economy during the incremental test. The gas exchange threshold and respiratory compensation point were observed for each test such that the associated metabolic rates, which bound the heavy-intensity domain during constant-work-rate exercise, could be determined. Significant correlations (Spearman's) were observed for exercise economy along with (a) peak rate of oxygen uptake (ρ = .562; p < 0.025), and (b) metabolic rate at gas exchange threshold (ρ = -.759; p < 0.005). A rapidly-incremented tethered-swimming test allows for determination of the metabolic rates that define zones for domain-specific constant-work-rate training.

Subspecies and diet affect the expression of genes involved in lipid metabolism and chemical composition of muscle in beef cattle.

Fourteen Nellore and 14 Angus young bulls with BW of 381±11.8kg were randomly assigned into 2 feeding groups (whole shelled corn without forage (WSC) or corn silage and ground corn (GC)) to evaluate chemical composition and expression of genes involved in lipid metabolism in the longissimus thoracis (LT). We hypothesized that bulls fed the WSC diet have greater amounts of intramuscular fat and Angus have higher expression levels of PPAR and SREBF. Meat from Angus bulls had greater ether extract compared to Nellore (P<0.05). Muscle from bulls fed the WSC diet had greater expression of PPARA (P<0.05) and lower levels of SREBF1 expression (P<0.01). The LT of Nellore fed GC had greater expression of FABP4, ACACA and SCD genes (P<0.01). In conclusion, the greater concentration of starch in the WSC diet did not increase marbling in the beef of bulls fed this diet due to the reduced expression of SREBF1.

Primary adenosquamous cell carcinoma of the pancreas: the use of endoscopic ultrasound guided - fine needle aspiration to establish a definitive cytologic diagnosis.

Pancreatic cancer is the second most common malignancy of the gastrointestinal tract in the US, and adenocarcinoma has been identified as the most common type of pancreatic cancer. Different types of pancreatic cancers have been classified: adenocarcinoma, ductal adenosquamous carcinoma, solid pseudopapillary tumors, endocrine neoplasms, acinar cell carcinoma, squamous cell carcinoma, cystic tumors, primary lymphoma of the pancreas, and metastatic lesions of the pancreas. Adenosquamous carcinoma is extremely rare, behave in a very aggressive way and is responsible for the 1 to 4% of the pancreatic exocrine neoplastic lesions. We describe the case of an 82-years-old African American female, presenting to our institution with quantifiable weight loss (12 kg in 3 months), jaundice and abdominal pain. On admission, laboratory tests were obtained: total bilirubin: 11.07 mg/dl with a direct fraction of 10.32 mg/dl. Cross-sectional abdominal CT scan with contrast, showed a lesion localized in the pancreatic head (hypodense on T1, measuring 3.5 x 3.5 x 2.5 cm), with vascular invasion of the portal vein. EUS showed a solid, hypoechoic, not well-defined lesion (measuring 3.98 x 3.80 cm), localized between the head and neck of the pancreas. EUS-FNA was performed with a 22G needle using the fanning technique. The cytological specimens demonstrated components of both squamous carcinoma and adenocarcinoma. The patient underwent ERCP procedure, and biliary drainage was performed with an entirely covered metallic stent placement. After a month from the procedures, the patient died due to the severity of the disease. Endoscopic ultrasound has proven to be the best method to diagnose solid pancreatic lesions, including rare and aggressive type of tumors like primary adenosquamous cell carcinoma that we described in this very interesting case report.

Endoscopic ultrasound versus magnetic resonance cholangiopancreatography in suspected choledocholithiasis: A systematic review.

BACKGROUND AND OBJECTIVES: There is a lack of consensus about the optimal noninvasive strategy for patients with suspected choledocholithiasis. Two previous systematic reviews used different methodologies not based on pretest probabilities that demonstrated no statistically significant difference between Endoscopic ultrasound (EUS) and magnetic resonance cholangiopancreatography (MRCP) for the detection of choledocholithiasis. In this article, we made a comparison of the diagnostic ability of EUS and MRCP to detect choledocholithiasis in suspected patients. METHODS: We conducted a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations with all published randomized prospective trials. We performed the systemic review using MedLine, EMBASE, Cochrane, LILACS, and Scopus reviews through May 2015. We identified eight randomized, prospective, blinded trials comparing EUS and MRCP. All the patients were submitted to a gold standard method. We calculated the study-specific variables and performed analyses using aggregated variables such as sensitivity, specificity, prevalence, positive predictive value (PPV) and negative predictive value (NPV), and accuracy. RESULTS: Five hundred and thirty eight patients were included in the analysis. The pretest probability for choledocholithiasis was 38.7. The mean sensitivity of EUS and MRCP for detection of choledocholithiasis was 93.7 and 83.5, respectively; the specificity was 88.5 and 91.5, respectively. Regarding EUS and MRCP, PPV was 89 and 87.8, respectively, and NPV was 96.9 and 87.8, respectively. The accuracy of EUS and MRCP was 93.3 and 89.7, respectively. CONCLUSIONS: For the same pretest probability of choledocholithiasis, EUS has higher posttest probability when the result is positive and a lower posttest probability when the result is negative compared with MRCP.