Frailty, Seasonal Sensitivity and Health-related Quality of Life in Older People Living in High Southern Latitudes: a Bayesian Analysis.

Background: In older people, a notable research gap exists regarding the intricate dynamics between frailty, seasonal sensitivity, and health-related quality of life (HRQoL). This study aimed to determine the association between frailty, seasonal sensitivity, and HRQoL in older people from high southern latitudes. Methods: A cross-sectional observational study was conducted. Frailty, seasonal sensitivity, and HRQoL measurements were self-reported by participants through questionnaires. A total of 118 older people were recruited from a local community. The participants were selected through intentional non-probabilistic sampling. Results: The adjusted models showed a trend where lower education was associated with a higher risk of frailty (BF = 0.218). For frailty and HRQoL, we observed a trend suggesting that HRQoL decreases with increasing severity of frailty (BF = 1.76). In addition, we observed a linear effect based on the severity of seasonal sensitivity, meaning that older people with higher perceived severity report a proportional decrease in HRQoL (BF = 6.66). Conclusion: Sociodemographic factors, such as lower education levels, have increased the risk of frailty. At the same time, frailty and seasonal sensitivity perceived severity were associated with a lower HRQoL in older people.

Cardiac autonomic regulation in response to functional power threshold testing in elite cyclists / Regulación autonómica cardiaca en respuesta a la prueba de umbral de potencia funcional en ciclistas deélite

Objective: To evaluate the impact of a functional power threshold test (FTP) on cardiac autonomic regulation indicators in high performance cyclists.Methods: A total of 12 male elite cyclists (mean age 36.1 ± 11.2 years) were recruited. Body composition parameters were measured usingbioimpedancemetry and heart rate variability (HRV) before and after the application of the FTP assessment. Results: We observed that a greater sympathetic nervous system (SNS) index and Stress index on baseline were correlated with a smaller decrease in theparasympathetic nervous system (PNS) activity in response to the FTP test (ρ= 0.69, p = 0.013). Concerning morphological parameters, the skeletalmuscle index (SMI) was the only one that was inversely correlated with ∆PNS (ρ= -0.69, p = 0.02) whereas the muscle-bone index (MBI) displayed apositive correlation with ∆SNS (ρ = 0.82, p = 0.001). In fully adjusted models we found that waist-to-hip ratio (β= 7.90, CI95%[4.16, 11.63], t(8) = 4.88, p =0.001) and SMI significantly influenced ∆PNS (β = -1.38, CI95%[-1.84, -0.92], t(8) = -6.94, p < 0.001), whereas MBI (β= 10.26, CI95%[8.10, 12.42], t(8) =10.96, p < 0.001) and the interaction between the latter and Power achieved during FTP influenced ∆SNS (β = -0.05, CI95%[-0.09, -4.99e-03], t(8) = -2.56, p= 0.033). Conclusion: Our findings indicate that the SMI had a negative effect on the ∆PNS, while the MBI was positively correlated with the ∆SNS in cyclists. Thesefindings suggest that a higher SMI and MBI could have a detrimental impact on the cardiac autonomic response to maximal aerobic exercise in high-performance cyclists, such as FTP.(AU)

Objetivo: Evaluar el impacto de una prueba de umbral de potencia funcional (FTP) sobre los indicadores de regulación autonómica cardiaca en ciclistasde alto rendimiento. Métodos: Se reclutó a un total de 12 ciclistas de élite masculinos (edad media 36.1 ± 11.2 años). Se midieron los parámetros de composición corporalmediante bioimpedanciometría y la variabilidad de la frecuencia cardiaca (HRV) antes y después de la aplicación de la evaluación del FTP. Resultados: Observamos que un mayor índice del sistema nervioso simpático (SNS) e índice de estrés basalmente se correlacionaron con una menordisminución de la actividad del sistema nervioso parasimpático (PNS) en respuesta a la prueba FTP (ρ= 0.69, p = 0.013). En cuanto a los parámetrosmorfológicos, el índice músculo esquelético (SMI) fue el único que se correlacionó inversamente con el ∆PNS (ρ= -0.69, p = 0.02) mientras que el índicemúsculo-hueso (MBI) mostró una correlación positiva con ∆SNS (ρ = 0.82, p = 0.001). En los modelos totalmente ajustados encontramos que la relacióncintura-cadera (β= 7.90, CI95%[4.16, 11.63], t(8) = 4.88, p = 0.001) y el SMI influían significativamente en el ∆PNS (β= -1.38, CI95%[-1.84, -0.92], t(8) = -6.94,p < 0.001), mientras que el MBI (β = 10.26, CI95%[8.10, 12.42], t(8) = 10.96, p < 0.001) y la interacción entre este último y la Potencia alcanzada durante elFTP influían en el ∆SNS (β= -0.05, CI95%[-0.09, -4.99e-03], t(8) = -2.56, p = 0.033). Conclusión: Nuestros hallazgos indican que el SMI tuvo un efecto negativo sobre el ∆PNS, mientras que el MBI se correlacionó positivamente con el ∆SNSen ciclistas. Estos hallazgos sugieren que un mayor SMI y MBI podrían tener un impacto perjudicial en la respuesta autonómica cardíaca al ejercicioaeróbico máximo en ciclistas de alto rendimiento, como el FTP.(AU)

Validity and Reliability of Short-Term Heart Rate Variability Parameters in Older People in Response to Physical Exercise.

BACKGROUND: Currently, and to the best of our knowledge, there is no standardized protocol to measure the effect of low- to moderate-intensity physical exercise on autonomic modulation focused in older people. AIM: Validate a test-retest short-term exercise protocol for measuring the autonomic response through HRV in older people. METHODS: A test-retest study design was used. The participants were selected through intentional non-probabilistic sampling. A total of 105 older people (male: 21.9%; female: 78.1%) were recruited from a local community. The assessment protocol evaluated HRV before and immediately after the 2-min step test. It was performed twice on the same day, considering a time of three chronological hours between the two measurements. RESULTS: The posterior distribution of estimated responses in the Bayesian framework suggests moderate to strong evidence favoring a null effect between measurements. In addition, there was moderate to robust agreement between heart rate variability (HRV) indices and assessments, except for low frequency and very low frequency, which showed weak agreement. CONCLUSIONS: Our results provide moderate to strong evidence for using HRV to measure cardiac autonomic response to moderate exercise, suggesting that it is sufficiently reliable to show similar results to those shown in this test-retest protocol.

Physical Activity, Seasonal Sensitivity and Psychological Well-Being of People of Different Age Groups Living in Extreme Environments.

Physical activity can prevent many organic and mental pathologies. For people living in extreme southern high-latitude environments, weather conditions can affect these activities, altering their psychological well-being and favoring the prevalence of seasonal sensitivity (SS). This study aims to determine the relationships between the practice of physical activity, seasonal sensitivity and well-being in people living in high southern latitudes. A cross-sectional study was conducted, using the Seasonal Pattern Assessment Questionnaire (SPAQ), applying a psychological well-being scale, and determining sports practice according to the recommendations of the World Health Organization (WHO) for the 370 male (n = 209; 55%) and female (n = 173; 45%) participants. The main results indicated that 194 people (52 ± 7.7 years) reported physical activity. High-intensity physical activity practitioners recorded a significantly lower proportion of SS. In terms of psychological well-being, an adverse effect was found between the Seasonal Score Index (SSI) and five subcategories of the Ryff well-being scale. In conclusion, those who perform high-intensity physical activity have a lower SS, and those who have a higher SS have a lower psychological well-being.

Características clínicas, comorbilidad y variables de laboratorio asociadas a la hospitalización y mortalidad de personas mayores con Covid-19: Una revisión sistemática

Objetivo: Caracterizar indicadores clínicos, comorbilidad y variables de laboratorio asociadas a la hospitalización y mortalidad de personas mayores con Covid-19. Materiales y métodos: Se realizó una revisión sistemática de acuerdo con la declaración PRISMA, en las bases de datos Medline/Pubmed, Science Direct y WOS, en la que se aplicaron estrategias de búsquedas específicas para artículos y estudios que fueron publicados desde el periodo de tiempo comprendido entre el 1 de enero de 2020 hasta el 26 de noviembre de 2020. Resultados: Se identificaron 28 artículos que cumplieron con los criterios de selección, con una suma del tamaño muestral de los estudios incluidos de 581 319 sujetos (55.1 % mujeres). De los factores analizados, un estado funcional óptimo, el sexo femenino, el recuento de linfocitos, el uso de anticoagulantes de manera curativa y los niveles de albúmina sérica, se han asociado a un mejor pronóstico clínico en adultos mayores de 65 años. Conclusiones: Se encontraron características clínicas, de comorbilidad y variables de laboratorio asociadas a la hospitalización y morbilidad.

Objective: To characterize clinical indicators, comorbidity and laboratory variables associated with hospitalization and mortality in older people with Covid-19. Materials and methods: A systematic review was carried out in accordance with the PRISMA statement, in the Medline/Pubmed, Science databases. Direct and WOS, in which specific search strategies were applied to articles and studies that were published from the period of time between January 1, 2020 and November 26, 2020. Results: 28 articles were identified that met the the selection criteria, with a sum of the sample size of the included studies of 581,319 subjects (55.1% women). Of the factors analyzed, optimal functional status, female gender, lymphocyte count, curative use of anticoagulants, and serum albumin levels have been associated with a better clinical prognosis in adults older than 65 years. Conclusions: Clinical characteristics, comorbidity and laboratory variables associated with hospitalization and morbidity were found.

Effect of Confinement on Anxiety Symptoms and Sleep Quality during the COVID-19 Pandemic.

Confinement during the COVID-19 pandemic has significantly impacted lifestyles worldwide. The aim of this study was to evaluate the effect of confinement on anxiety symptoms and sleep quality in people living in extreme southern latitudes. The Beck Anxiety Inventory (BAI) and the Pittsburgh Sleep Quality Index (PSQI) were administered to 617 people, 74.2% of whom were women. The sample was grouped according to confinement: the zone of confinement (CZ) (46.5%) and the zone of partial confinement (PZ) (53.5%). In addition, the sample was further categorized into four age subgroups (18-25 years; 26-40 years; 41-50 years; over 50 years). Higher levels of anxiety and worse sleep quality were found in the CZ group than in the PZ group. Women had higher levels of anxiety and worse sleep quality than men. A significant bidirectional relationship between anxiety and sleep quality was observed, even after controlling for sex. This study demonstrated that women and young adults were more vulnerable to the effects of confinement on anxiety symptoms and sleep quality in populations at southern latitudes.

Relationship of cardiorespiratory control and vascular compliance in competitive young athletes / Relación entre el control cardiorrespiratorio y la distensibilidad vascular en atletas jóvenes de competición / Relação entre o controlo cardiorrespiratório e a conformidade vascular em jovens atletas competitivos

Objective: To study the haemodynamic properties of the peripheral circulation and its relationship with cardiorespiratory control, during anaerobicmuscle fatigue test, in young competitive athletes.Method: Nine adolescent of national and international competition level were recruited (age: 15.6 ± 1.9 years; male = 7) and cross-evaluated. Morphological measurements (body mass, percentage of total body fat and height), blood pressure (systolic, diastolic, mean and pulse blood pressure),respiratory measures (spirometry and pimometry), power, and fatigue were recorded through Wingate test.Results: Weight, height, and fat-free mass were positively correlated with the power parameters of the Wingate test (p < 0.05). The respiratoryparameters of forced vital capacity, peak expiratory flow, maximum inspiratory pressure (MIP) and maximum sustained pressure (SMIP) were alsosignificantly correlated with the power parameters. Additionally, the cardiorespiratory parameters of MIP and SMIP were positively correlated with pulsepressure at rest (p < 0.05).Conclusion: The increase in MIP and SMIP is associated with a lower arterial compliance, which indicates that a lower vascular elasticity influences agreater diaphragmatic strength and endurance of the young athlete.(AU)

Objetivo: Estudiar las propiedades hemodinámicas de la circulación periférica y su relación con el control cardiorrespiratorio, durante la prueba de fatiga muscular anaeróbica, en jóvenes atletas de competición.Método: Se reclutaron nueve adolescentes de nivel de competición nacional e internacional (edad: 15.6 ± 1.9 años; hombres = 7) y se evaluaron de forma cruzada. Se registraron medidas morfológicas (masa corporal, porcentaje de grasa corporal total y altura), presión arterial (presión arterial sistólica, diastólica, media y pulso), medidas respiratorias (espirometría y pimometría), potencia y fatiga mediante el test de Wingate. Resultados: El peso, la altura y la masa libre de grasa se correlacionaron positivamente con los parámetros de potencia del test de Wingate (p < 0.05). Los parámetros respiratorios de capacidad vital forzada, flujo espiratorio máximo, presión inspiratoria máxima (MIP) y presión inspiratoria máxima sostenida (SMIP) también se correlacionaron significativamente con los parámetros de potencia. Además, los parámetros cardiorrespiratorios de MIP ySMIP se correlacionaron positivamente con la presión del pulso en reposo (p < 0.05).Conclusión: El aumento de la MIP y SMIP se asocia a una menor compliance arterial, lo que indica que una menor elasticidad vascular influye en una mayor fuerza y resistencia diafragmática del joven atleta.(A)

Objetivo: Estudar as propriedades hemodinâmicas da circulação periférica e sua relação com o controle cardiorrespiratório, durante o teste de fadigamuscular anaeróbica, em jovens atletas competitivos.Método: Nove adolescentes de nível de competição nacional e internacional foram recrutados (idade: 15.6 ± 1.9 anos; masculino = 7) e avaliados de formacruzada. Medidas morfológicas (massa corporal, percentual de gordura corporal total e altura), pressão arterial (sistólica, diastólica, média e pulso),medidas respiratórias (espirometria e pimometria), potência e fadiga foram registradas através do teste Wingate.Resultados: Peso, altura e massa livre de gordura foram correlacionados positivamente com os parâmetros de potência do teste Wingate (p < 0.05). Osparâmetros respiratórios de capacidade vital forçada, pico de fluxo expiratório, pressão inspiratória máxima (MIP) e pressão inspiratória máximasustentada (SMIP) também foram significativamente correlacionados com os parâmetros de potência. Além disso, os parâmetros cardiorespiratórios daMIP e SMIP foram positivamente correlacionados com a pressão de pulso em repouso (p < 0.05).Conclusão: O aumento da MIP e SMIP está associado a uma menor complacência arterial, o que indica que uma menor elasticidade vascular influenciauma maior resistência diafragmática e resistência do jovem atleta.(AU)

[Functional characterization of patients with cerebral palsy living in the Magallanes region and the Chilean Antarctic]. / Caracterización funcional de pacientes con parálisis cerebral que viven en la región de Magallanes y la Antártica Chilena.

OBJECTIVE: To functionally characterize patients with Cerebral Palsy (CP) living in the Magallanes Re gion and the Chilean Antarctic. PATIENT AND METHOD: Descriptive-retrospective observational study of patients with cerebral palsy, registered in the Outpatient Rehabilitation Program of the Corporación de Rehabilitación Club de Leones Cruz del Sur de Punta Arenas between 1986 and 2018. Patients with CP were clinically categorized and then functionally characterized according to gross motor skills (GMFCS), manual ability (MACS), feeding ability (EDACS), and communication function (CFCS). RESULTS: 106 patients were included. Regarding the clinical classification, the most common type of CP was bilateral spastic paralysis, with the highest percentage of functional involvement in each of the evaluated areas, followed by unilateral spastic paralysis, while cases of dystonic CP and other non-classifiable types presented were less frequent. According to the clinical subclassification, spastic diplegia was more frequent, especially affecting manual and communication skills level I compared with hemiplegia, while cases of mixed and unclassifiable quadriplegia were less frequent with greater overall involvement of level I feeding skills. CONCLUSION: The observed results of CP in the Magalla nes Region and the Chilean Antarctic are similar to studies available in the literature. The complete evaluation and classification of patients with CP enable a better understanding of the pathology for future studies.

Cardiac Autonomic Modulation in Response to Muscle Fatigue and Sex Differences During Consecutive Competition Periods in Young Swimmers: A Longitudinal Study.

Objective: To study the differences in cardiac autonomic modulation in response to muscle fatigue caused by high-intensity exercise during two consecutive competition periods in young swimmers. Methods: Twenty-six competitive swimmers, selected by their training volume, were separated in two groups, females (n = 12 [46%], age: 13.5 ± 1.4 years) and males (n = 14 [54%], age: 13.9 ± 1.7 years), aged between 10 and 16 years, were evaluated five times as follow: (i) 21 days before the first competition (t-0); (ii) two days before (t-1; t-3); and (iii) two days after (t-2; t-4) of the first and second competitions. Morphological measurements (body mass, percentage of total body fat and height), blood pressure, power, and resting heart rate variability (RR with Polar band) were recorded before and after Wingate test at each time. Results: Body fat was higher in females compared to males. However, no differences were found in other morphological parameters. An intra-subject analysis grouped by sex in cardiovascular parameters shows longitudinal variations in systolic pressure and mean pressure among females. Additionally, females depicted higher, very low frequency (VLF, which is intrinsically generated by the heart and strongly associated with emotional stress) after physical fatigue compared to males at t-1. Further, before the competition, the high frequency (HF) component of HRV (parasympathetic drive) was higher in males than females at t-0 and t-4. Conclusion: Our data revealed that males displayed greater parasympathetic reactivity after an anaerobic muscle fatigue test during their competition periods. Contrarily, females had a less cardiac autonomic modulation when comparing the pre-post Wingate test after two consecutive competition periods.

Asociación entre el índice de masa corporal y la regulación del sistema cardiovascular en estudiantes de medicina. Un estudio piloto / Association between body mass index and regulation of the cardiovascular system in medical students. A pilot study

Objetivo: determinar la existencia de una asociación entre el índice de masa corporal y la regulación cardiovascular en estudiantes de medicina. Materiales y métodos: estudio transversal con un diseño aleatorio. La muestra se compuso por 54 estudiantes de medicina (21,2 ± 1,6 años) evaluados y clasificados según el índice de masa corporal: normopeso (NP; IMC < 25 kg/m2); sobrepeso (SP; IMC≥ 25 kg/m2); obesos (OB; IMC ≥ a 30 Kg/m2). Las medidas antropométricas, presión arterial y variabilidad de frecuencia cardiaca (HRV) fueron las variables evaluadas. Resultados: el 51,9% de los estudiantes presenta sobrepeso u obesidad. El índice de masa corporal correlaciona negativamente con el parámetro de variabilidad de frecuencia cardíaca, especialmente al compararla en los dominios de tiempo de HRV (p<0,001). También se observaron diferencias en el control autonómico cardíaco al comparar los grupos de estudio en LnRMSSD (p<0,01) y LnSDNN (p<0,01). Conclusión: la implementación de medidas que disminuyan los valores de IMC posibilitará un mayor control autonómico cardíaco y mejor salud cardiovascular en estudiantes de medicina..(Au)

Objective: this study had the purpose of knowing the association of the body mass index and cardiovascular regulation of medical students. Materials and methods: a cross-sectional study with a randomized design. The sample consisted of 54 medical students (21,2 ± 1,6 years) who were evaluated and classified according to the body mass index: Normal weight (NP; BMI <25 kg / m2); Overweight (SP; BMI≥ 25 kg / m2); Obese (OB; BMI ≥ 30 Kg / m2). Anthropometric measurements, blood pressure, and heart rate variability (HRV) were the variables evaluated. Results: 51,9% of the students are overweight or obese. The body mass index was negatively correlated with the heart rate variability parameter, especially when compared with the HRV time domains (p <0.001). Differences were also observed in cardiac autonomic control when comparing the study groups in LnRMSSD (p <0,01) and LnSDNN (p <0,01). Conclusion: the implementation of measures that decrease BMI values will allow greater autonomic cardiac control and better cardiovascular health in medical students..(Au)