Walk or be walked by the dog? The attachment role.

BACKGROUND: The human-animal bond has been recognized as having positive effects on the health and well-being of both humans and pets. The present study aims to explore the influence of attachment on physical activity (PA), lifestyle, and health outcomes of dog owners (DO), highlighting the mutual benefits resulting from the relationship between DO and dogs. METHODS: Thirty-eight DO and their dogs participated in this study. Socio-demographic data, the Self-Rated Health (SRH), FANTASTICO Lifestyle Scale, and the Lexington Attachment Pet Scale (LAPS) were assessed. PA was measured in both the DO and the dogs, using an ActiGraph GT3X accelerometer in the context of daily routine. Descriptive statistics and Spearman rank correlation analyses were performed to examine the associations between LAPS, PA levels, socio-demographic variables, lifestyle behaviors, and SRH. RESULTS: Significant correlations were found between the dog owners' light-level PA and the pets' vigorous level of PA (rho = 0.445, p = 0.01). Furthermore, the importance of the pets' health (rho = -0.785, p = 0.02) and the LAPS subscales, namely proximity (rho = 0.358, p = 0.03), and attachment (rho = 0.392, p = 0.01), were related to taking the pet for a walk. Regarding lifestyle, DO with a healthier lifestyle had a better self-assessment of their health using the SRH (rho = 0.39, p = 0.02). Moreover, DO with better lifestyles also exhibited greater concern for their pet's health (rho = 0.398, p = 0.01). CONCLUSIONS: This study emphasizes that individuals who adopt healthier habits tend to perceive themselves as healthier and exhibit greater concern for their pets' health. The attachment between DO and dogs is important in promoting healthy lifestyle behaviors and engagement in PA. Our results highlight that the presence of a dog is associated with a higher level of PA in DO, depending on the strength of the human-animal bond.

Effects of exercise programs on cardiorespiratory fitness and arterial stiffness on postmenopausal women: A systematic review study.

BACKGROUND: Arterial stiffness is an important marker of cardiovascular disease, with a considerable increase in menopause. The impact of exercise, as a preventive measure, on controlling the progression of cardiovascular disease and arterial dysfunction in middle age remains under investigation. OBJECTIVE: This systematic review aims to present the results of studies that examined the effects of different exercise programs (isolated, aerobic, and resistance or combined) on arterial stiffness and cardiorespiratory fitness in postmenopausal women. METHODS: Based on PRISMA guidelines, B-On, BioMed, EBSCOhost, MEDLINE, ScienceOpen, PubMed, Science Direct, Scopus, Web of Science, Cochrane library and LILACS databases were searched using specific keywords. RESULTS: A final total of 13 manuscripts were included in the qualitative synthesis, involving 700 participants. Four studies used only cardiorespiratory exercise, three only resistance, taekwondo class or flexibility exercise, and six combined exercise programs. Most interventions ranged from 3 to 5 days per week. Carotid-femoral pulse wave velocity showed improvements between 0.22 m/s and 1.56 m/s. In addition, one study showed an improvement of 4.4 ml/kg/min in maximal oxygen consumption. In 7 studies, participation in exercise programs improved arterial stiffness. CONCLUSIONS: Combined exercise (aerobic and resistance exercise) and aerobic exercise alone (swimming) improve cardiorespiratory fitness and arterial stiffness in postmenopausal women, particularly pulse wave velocity. The combined exercise program is the most effective, promoting improvements of up to -2.6 m/s in pulse wave velocity in this climacteric phase.

Six-month effects of supervised exercise on walking ability and health-related factors in peripheral arterial disease: a pilot study.

BACKGROUND: In peripheral arterial disease (PAD) patients with intermittent claudication (IC), the combination of aerobic and resistance exercises could counteract muscle loss and attenuate disease progression. This study analyzed the effects of six months of a combined exercise program on walking ability, lower limb body composition, cardiovascular risk factors, and Ankle-Brachial Index (ABI). METHODS: Twenty-three patients (age 63.2±1.5 years and ABI 0.58±0.07) with PAD and IC were allocated to a control group (CG) or a supervised exercise group (SUP). Ten patients underwent six months of treadmill walking combined with resistance exercises, three times a week. The CG (N.=13) received a recommendation for walking. All patients were measured at baseline (M0), after three months (M3), and six months (M6). RESULTS: During constant treadmill protocol, the claudication onset time/distance (COT/COD), absolute claudication time/distance (ACT/ACD), and number of pauses of overall patients significantly improved at M3 and M6. Between groups were found significant differences in COT and COD at M6 (P=0.005 and P=0.007, respectively); and in ACT and ACD at M3 (P=0.003 for both) and at M6 (P=0.005 and P=0.005, respectively), with major improvements in the SUP. Over the six months, a significant group effect was found in fat-free mass (P=0.041) and predicted muscle mass (P=0.039) of the lower ABI leg, with greater improvements in the SUP. CONCLUSIONS: A supervised exercise program that combines aerobic and resistance training improves PAD symptoms and has additional benefits for patients. Patients in the program showed improvements in walking ability, lower-limb body composition, perceived exertion, and heart rate during treadmill walking.

Comparing the effects of dynamic and holding isometric contractions on cardiovascular, perceptual, and near-infrared spectroscopy parameters: A pilot study.

The aim of this pilot study was to assess the effect of muscle contraction type on SmO2 during a dynamic contraction protocol (DYN) and a holding isometric contraction protocol (ISO) in the back squat exercise. Ten voluntary participants (age: 26.6 ± 5.0 years, height: 176.8 ± 8.0 cm, body mass: 76.7 ± 8.1 kg, and one-repetition maximum (1RM): 112.0 ± 33.1 kg) with back squat experience were recruited. The DYN consisted of 3 sets of 16 repetitions at 50% of 1RM (56.0 ± 17.4 kg), with a 120-second rest interval between sets and 2 seconds per movement cycle. The ISO consisted of 3 sets of 1 isometric contraction with the same weight and duration as the DYN (32 seconds). Through near-infrared spectroscopy (NIRS) in the vastus lateralis (VL), soleus (SL), longissimus (LG), and semitendinosus (ST) muscles, the minimum SmO2 (SmO2 min), mean SmO2 (SmO2 avg), percent change from baseline (SmO2 Δdeoxy) and time to recovery 50% of baseline value (t SmO2 50%reoxy) were determined. No changes in SmO2 avg were found in the VL, LG, and ST muscles, however the SL muscle had lower values in DYN, in the 1st set (p = 0.002) and in the 2nd set (p = 0.044). In terms of SmO2 min and ΔSmO2 deoxy, only the SL muscle showed differences (p≤0.05) and lower values in the DYN compared to ISO regardless of the set. The t SmO2 50%reoxy was higher in the VL muscle after ISO, only in the 3rd set. These preliminary data suggested that varying the type of muscle contraction in back squat with the same load and exercise time resulted in a lower SmO2 min in the SL muscle in DYN, most likely because of a higher demand for specialized muscle activation, indicating a larger oxygen supply-consumption gap.

A Case of Peritoneal Dialysis-Related Peritonitis Caused by Ewingella americana.

Peritoneal dialysis (PD)-related peritonitis is a frequent complication. PD units should be aware of all possible pathogens and share their experience about prevention and optimal management. Uncommon bacteria, a special group with crescent incidence in PD practice, may require singular considerations. A case of peritonitis due to Ewingella americana, a rare human pathogen, is reported, with a favorable outcome. To date, only three other cases have been described in the literature. New evidence is necessary for a better understanding of this pathogen and its consequences in PD modality.

Physiological Exercise and Post-Exercise Effects of Inverse Sequences of Combined Bench-Step Aerobics and Resistance Exercise.

The purpose of this study was to compare the effects of using inverse sequences of combined bench-step aerobics and resistance exercise on cardiorespiratory, hemodynamic and perceptual variables during exercise and one-hour post-exercise. The tested sequences were bench-step aerobics immediately before and immediately after resistance exercise. Thirteen apparently healthy and physically active women (age = 21.9 ± 6.1 years, body height = 160 ± 0.1 cm, body mass = 58.8 ± 7.5 kg, estimated fat mass = 17.2 ± 2.0% and estimated maximal oxygen uptake = 37.5 ± 2.6 mL∙kg-1∙min-1) performed a 20-minute bench-step aerobics routine, immediately before (STEP_RES) and after (RES_STEP) resistance exercise. Oxygen uptake and heart rate were continuously measured, systolic and diastolic blood pressure, body temperature and perceived exertion were measured at rest, immediately after each type of exercise and at 15, 30, 45 and 60 min after exercise. When resistance exercise was performed first (RES_STEP), oxygen uptake was higher (23.2 ± 3.9 vs. 20.5 ± 4.8 mL∙kg-1∙min-1), but the heart rate (164.5 ± 9.1 vs. 173.9 ± 11.7 bpm) and body temperature (36.5 ± 0.4 vs. 37.6 ± 0.6 ºC) were lower. In both sequences, the type of exercise performed first was pointed out with a lower perceived exertion or lower perceived intensity. Exercise and 60-min post-exercise blood pressure had a similar response in both sequences, and systolic blood pressure along with diastolic blood pressure were lower than pre-exercise from 30 min until 60 min post-exercise. The results suggest that the sequence affected oxygen uptake and perceived exertion during exercise and that this total workload, despite the sequence, promoted a post-exercise blood pressure decrease in normotensive participants.

Implications of a defined daily dose fixed database for drug utilization research studies: The case of statins in Portugal.

AIMS: Given the discrepancies between PDDs (prescribed daily doses) and DDDs (defined daily doses), we aimed to assess the extent of error in the results of an 18-year population-level study on statin utilization in Portugal. METHODS: The Portuguese regulatory agency provided data for the period 2000-2018 on statin dispensing (C10AA). The DDDs were gathered from the ATC/DDD database. DDDs were calculated by the DDD year-by-year approach (DDDYEAR ) and by the DDD last-year approach (DDDLAST ). PDDs were calculated according to the year-by-year approach (PDDYEAR ). Statin annual utilization rates per 1000 inhabitants per day were also calculated. Percent errors were calculated for PDDYEAR and DDDYEAR units. RESULTS: The DDDYEAR approach revealed decreases in the consumption of atorvastatin, fluvastatin, lovastatin, pravastatin and simvastatin in 2009, when their DDD was modified. Conversely, the results from both DDDLAST and PDDYEAR approaches indicated gradual changes in the actual consumption of all statins in Portugal. Before 2009, atorvastatin, pravastatin and simvastatin utilization was greatly overestimated by DDDYEAR /1000 inhabitants/day. The average dose of lovastatin prescribed in the past 18 years (20 mg) was below the assigned DDDs during the study period, varying from 30 mg to 45 mg. Conversely, the PDD for fluvastatin was above the DDD values (ranging from 40 mg in 2000 to 70 mg in 2016). For atorvastatin, pravastatin and simvastatin, national PDDs were above the assigned DDD until the DDD modification in 2009. CONCLUSIONS: A more dynamic system, based on national and annually updated DDDs, should be able to reduce discrepancies between DDDs and PDDs and the bias in utilization studies.

Use of Peritoneal Catheters for Patients Receiving Palliative Care.

Background: Recurrent ascites is a late manifestation of several diseases, including cancer, cirrhosis, and heart failure, invariably associated with very poor prognosis. Hence, every effort must be aimed at reducing discomfort and side effects of its management. Objective: To evaluate if peritoneal catheters (PCs) are a viable alternative treatment approach in palliative patients who fail medical management of ascites. Design: Case study. Results: We report the case of a terminal patient with cirrhosis and hepatocellular carcinoma who presented refractory ascites despite serial large-volume paracentesis. A Tenckhoff percutaneous catheter was inserted, allowing for ascites' control and with no complications noted. Conclusions: PC placement was successful in controlling the patient's symptoms and ultimately improved comfort and well-being during the final stage of his life. This option should be assessed in selected patients to elevate palliative standards of care.

Hemodialysis Catheter-Related Thrombi: A Challenging Patient.

Patients requiring renal replacement therapy remain a significant burden on the healthcare system. A substantial amount of hospitalization costs for these patients are related to vascular complications, especially catheter-related thrombosis, which is associated with a significant increase in morbidity and mortality. We report the case of a male patient with multiple myeloma (MM) and dialysis-dependent renal failure due to light-chain cast nephropathy, who presented recurrent early catheter dysfunction. A large thrombus was detected, extending from the superior vena cava (SVC) to the right atrium (RA) and later at the inferior vena cava (IVC), ultimately leading to exhaustion of vascular capital. To this date, there is limited evidence regarding the best approach to catheter-related thrombosis, which frequently leads to treatment dilemmas in clinical practice and demands careful evaluation and individualized decisions. In patients with a highly thrombotic profile, peritoneal dialysis may be considered earlier to prevent further vascular capital damage.

An unexpected cause of residual renal function loss.

The residual renal function (RRF) in a peritoneal dialysis (PD) patient is clinically important because it contributes to dialytic adequacy, quality of life and mortality. We present the case of a patient in PD with a marked decrease in RRF. Even after the increase of dialysis, the patient maintained asthenia and anorexia, was prostrate and showed no improvement analytically. The study revealed hypothyroidism, iatrogenic due to the use of amiodarone. After suspension of the drug and replacement with levothyroxine, there was a normalization of thyroid function and recovery of RRF to baseline values. A thyroid dysfunction is associated with several changes in renal function, in most cases reversible after obtaining euthyroid state. The association between thyroid dysfunction and loss of RRF continues to be under-recognized. We should consider monitoring thyroid function annually as routine in this group of patients.

Fitness, Technical, and Kinanthropometrical Profile of Youth Lithuanian Basketball Players Aged 7-17 Years Old.

Optimizing basketball performance during the stages of long-term athlete development require to identify the trainability and variation of specific technical skills, when adjusting for anthropometric changes. The aim of this study was to describe differences in height, body mass, arm span, and technical-related fitness (movement, dribbling, shooting) along the long-term development of 7-17 years Lithuanian basketball players. This cross-sectional analysis involved a total of 1051 basketball players from the Sabonis Basketball Center in Lithuania. Testing sessions were performed during 1 day of the competition period in an indoor court. The participants performed technical-related fitness tests to assess dribbling (control dribble, 20 m dribble, two balls of 20 m dribble, Illinois agility dribble), shooting (30 free-throw shoots, 1 min shooting, modified medium and long-range shots, close range shots) and defensive movements. The dribbling skills had substantial improvements (7 to 8-years-old: 20 m sprint with dribbling, effect size = 1.86; control dribble effect size = 2.18; 9 to 10-year-old: 20 m sprint with dribbling, effect size = 1.85; Illinois agility test with dribbling effect size = 1.82). Changes in defensive movement occurred mostly at the 14-15-age period. The best periods to develop dribbling and shooting skills were between 7-10 and 12-13 years, whereas defensive movements can be trained in later adolescent years. Current results and consequent normative profiles, presented as percentile tables, allow to accurately follow the players' development.

Entropy Measures Can Add Novel Information to Reveal How Runners' Heart Rate and Speed Are Regulated by Different Environments.

Ecological psychology suggests performer-environment relationship is the appropriate scale for examining the relationship between perception, action and cognition. Developing performance requires variation in practice in order to design the attractor-fluctuation landscape. The present study aimed to identify the effects of varying levels of familiarity and sensorimotor stimuli within the environment in runners' speed and heart rate (HR) regularity degree, and short-term memory Twelve amateur runners accomplished three 45-min running trials in their usual route, in an unusual route, and an athletics 400-m track, wearing a GPS and an HR monitor. Sample entropy (SampEn) and complexity index (CI), over speed and HR, were calculated. Pre and post-trial, participants performed the Backward Digit Span task for cognitive assessment. Higher entropies were found for the 400-m track, compared to the usual and unusual routes. Usual routes increased speed SampEn (63% of chances), but decreased HR CI when compared to unusual routes (60% of chances). Runners showed higher overall short-term memory performance after unusual routes, when compared to usual routes (85% of chances), indicating positive relation to attentional control. The contexts of practice may contribute to change predictability from single to multiple timescales. Thus, by considering that time structuring issues can help diagnosing habituation of training routes, this study brings novel information to the long-term process of training.

Combined Aerobic and Resistance Exercise in Walking Performance of Patients With Intermittent Claudication: Systematic Review.

Background: The short-term benefits of aerobic and resistance exercise in subjects affected by Peripheral Arterial Disease (PAD) are scarcely examined in interaction. This study aimed to identify the effects of combined aerobic and resistance exercise programs on walking performance compared with isolated aerobic exercise or with the usual care in patients with intermittent claudication. Methods: A systematic review was conducted following the PRISMA statement. A total of five electronic databases were searched (until October 2019) for randomized and non-randomized controlled trials. The focus comprised PAD patients with intermittent claudication who performed a combined aerobic and resistance exercise program that assessed the walking performance. Results: Seven studies include combined aerobic and resistance exercise vs. isolated aerobic or vs. usual care. The studies represented a sample size of 337 participants. The follow-up ranged from 4 to 12 weeks, 2 to 5 times-per-week. The risk of bias in the trials was a deemed moderate-to-high risk. After the interventions, the percent change in walking performance outcomes had a large variation. In the combined and isolated aerobic programs, the walking performance always improved, while in the usual care group oscillates between the deterioration and the improvement in all outcomes. Combined exercise and isolated aerobic exercise improved the claudication onset distance from 11 to 396%, and 30 to 422%, the absolute claudication distance from 81 to 197%, and 53 to 121%, and the maximal walking distance around 23 and 10%, respectively. Conclusions: Currently, there is insufficient evidence about the effects of combined aerobic and resistance exercise compared to isolated aerobic exercise or usual care on walking performance. However, despite the low quality of evidence, the combined aerobic and resistance exercise seems to be an effective strategy to improve walking performance in patients with intermittent claudication. These combined exercise modes or isolated aerobic exercise produce positive and significant results on walking performance. The usual care approach has a trend to deteriorate the walking performance. Thus, given the scarcity of data, new randomized controlled trial studies that include assessments of cardiovascular risk factors are urgently required to better determine the effect of this exercise combination.

Hypocalcaemia in an adult: the importance of not overlooking the cause.

A 58-year-old male patient was admitted at the São Bernardos's Hospital (Setúbal, Portugal) with generalised muscle spasms, dyspnoea, laryngospasm and bronchospasm in the context of severe hypocalcaemia. Despite efforts to correct serum calcium, it remained below average, leading to question the true cause of hypocalcaemia. Low parathyroid hormone and 25-hydroxyvitamin D, along with facial anomalies, palate defect and cognitive impairment with concomitant psychiatric disorder led to a suspicion of a DiGeorge/velocardiofacial/22q11.2 deletion syndrome (DS), which was confirmed through genetic testing. The 22q11.2 DS has a wide phenotypic expression and there are growing reports of diagnosis being made in adulthood. This case report highlights the importance of understanding the cause of refractory hypocalcaemia and alerts medical community to carefully access these patients, for this metabolic disorder may only present in later stages of life.

Effectiveness of combined exercise training to improve functional fitness in older adults: A randomized controlled trial.

AIM: The present randomized controlled trial evaluated the impact of different exercise training modalities on functional fitness responses in apparently healthy older men. METHODS: A total of 59 community-dwelling older men were randomly assigned to an aerobic training group (ATG, n=19), a combined aerobic and resistance training group (CTG, n=20) or a control group (n=20). Both exercise training programs were moderate-to-vigorous intensity, 3 days/week for 9 months. Six independent functional fitness tests (back scratch, chair sit-and-reach, 30-s chair stand, arm curl, 8-ft up-and-go, 6-min walk) were measured on five different occasions. The data were analyzed using a mixed-model ANOVA. RESULTS: ANOVA showed a significant main effect of group (P<0.001) for all functional fitness tests, with significant differences between both training groups and controls. However, the ATG only improved the chair sit-and-reach and the 30-s chair stand performance, whereas CTG improved in all functional fitness tests. ANOVA also identified a significant main effect of time for 8-ft up-and-go (P=0.031) in the CTG. CONCLUSIONS: Only the combined exercise program was effective in improving all functional fitness components related to daily living activities.

Progressive resistance strength training and the related injuries in older adults: the susceptibility of the shoulder.

The benefits of progressive resistance training (PRT) among the older adults are evident, especially in the prevention of sarcopenia and improving muscle strength, which reverse the age-related loss of functional ability. However, PRT carries some risk, particularly when participants are older adults with a certain degree of muscle weakness. The purpose of this article is to discuss the PRT-related injuries, and present an overview of documented shoulder injuries among the elderly, discerning possible mechanisms of injury and risk factors. A literature search was conducted in the PUBMED database to identify the relevant literature using combinations of keywords: strength-training injuries, resistance-training injuries, sports injuries in the elderly, shoulder complex, shoulder injury, and shoulder disorder. Acute and chronic injuries attributed to PRT have been cited in the epidemiological literature. The shoulder complex, has been alluded to as one of the most prevalent regions of injury, particularly in exercises that place the arm extended above the head and posterior to the trunk. However, the risk for injuries appears to be higher for testing than for training itself. One-repetition maximum strength testing may result in a greater injury risk. This technique, though acceptable, needs additional precautions in inexperience older adults to prevent injury. Thus, the best treatment for PRT age-related injuries is prevention. Appropriate and individualized training programs, the use of safe equipment, careful warming up and cooling down, correct range of motion, progressive intensity training, cardiovascular and musculoskeletal fitness are essential aspects of injury prevention among the elderly.