The effects of high-intensity functional training on cardiometabolic risk factors and exercise enjoyment in men and women with metabolic syndrome: study protocol for a randomized, 12-week, dose-response trial.

BACKGROUND: Individuals with metabolic syndrome (MetS) are at a greater risk for developing atherosclerotic cardiovascular disease (ASCVD) than those without MetS, due to underlying endothelial dysfunction, dyslipidemia, and insulin resistance. Exercise is an effective primary and secondary prevention strategy for MetS; however, less than 25% of adults meet the minimum stated public recommendations. Barriers often identified are lack of enjoyment and lack of time. High-intensity functional training (HIFT), a time-efficient modality of exercise, has shown some potential to elicit positive affectivity and elicit increased fitness and improved glucose metabolism. However, the effects of HIFT on dyslipidemia and endothelial dysfunction have not been explored nor have the effects been explored in a population with MetS. Additionally, no studies have investigated the minimal dose of HIFT per week to see clinically meaningful changes in cardiometabolic health. The purpose of this study is to (1) determine the dose-response effect of HIFT on blood lipids, insulin resistance, and endothelial function and (2) determine the dose-response effect of HIFT on body composition, fitness, and perceived enjoyment and intention to continue the exercise. METHODS/DESIGN: In this randomized, dose-response trial, participants will undergo a 12-week HIFT intervention of either 1 day/week, 2 days/week, or 3 days/week of supervised, progressive exercise. Outcomes assessed at baseline and post-intervention will be multiple cardiometabolic markers, and fitness. Additionally, the participant's affective response will be measured after the intervention. DISCUSSION: The findings of this research will provide evidence on the minimal dose of HIFT per week to see clinically meaningful improvements in the risk factors of MetS, as well as whether this modality is likely to mitigate the barriers to exercise. If an effective dose of HIFT per week is determined and if this modality is perceived positively, it may provide exercise specialists and health care providers a tool to prevent and treat MetS. TRIAL REGISTRATION: ClinicalTrials.gov NCT05001126 . August 11, 2021.

Anestesia espinal unilateral para cirugía ortopédica ambulatoria: evaluación de una dosis mínima de bupivacaína hiperbara asociada a lateralización: ¿es posible el éxito? / Unilateral spinal anaesthesis for orthopaedic ambulatory surgery: evaluation of a mininal dose of hyperbaric bupivacaine associated with side positioning: Is success posible?

INTRODUCCIÓN: la anestesia espinal unilateral (AEU) es una alternativa para el desarrollo de la cirugía ortopédica ambulatoria (COA). el OBJETIVO de este ensayo clínico fue el evaluar una dosis baja de bupivacaína hiperbara (BHB), asociada a fentanilo intratecal (FI) para obtención de AEU en COA. MATERIALES Y MÉTODOS: ensayo clínico, prospectivo, controlado en pacientes ASA I a II. la AEU se efectuó con el paciente en decúbito lateral (DL), con el lado operatorio hacia abajo, a nivel de L3-L4. se inyectó 5 mg de BHB 0,75% asociado a 20 µg de FI. se evaluó el bloqueo sensitivo (BS) y motor (BM) cada 3 minutos, los primeros 20 minutos y luego cada 15 minutos. Se midió el nivel máximo alcanzado, el tiempo de regresión a T12 y el tiempo de regresión de dos segmentos. se registró la incidencia de complicaciones. RESULTADOS: 50 pacientes fueron incluidos, 66% de sexo masculino. Se obtuvo anestesia unilateral en el 84% y BM total unilateral en el 86%. La altura del BS osciló entre T9 y T11. la duración del BS fue 116 min. (SD± 23). la regresión a T12 fue de 47 min (SD±19). No se encontró correlación entre talla, dosis y duración de bloqueo. ningún paciente necesitó anestesia general. 1 paciente presentó bradicardia. DISCUSIÓN: la AEU con dosis bajas de BHB asociado a FI es eficiente en COA. se obtuvo adecuados BS y BM en la mayoría de los pacientes. la AEU mostró ser confiable, permitiendo una alta precoz y segura.

INTRODUCTION: The unilateral spinal anesthesia (USA) is an alternative for orthopedic ambulatory surgery (OAS). The AIM of this study was to evaluate a low dose of hyperbaric bupivacaine (HB) associated with intrathecal fentanyl (ITF) to produce USA. MATERIALS AND METHODS: Prospective, controlled clinical trial in ASA I ­II patients. The USA was developed in lateral position with the operating side downwards between L3-L4 space with 5 mg of HB + 20 µg ITF. We evaluated sensitive level block (SB), motor level block (MB), maximum level obtained, discharge time (DT) and collateral effects incidence. RESULTS: 50 patients were included, 66% male. The USA was obtained in 84% and total BM was present in 86% of cases. The level obtained of SB was between T9-T11 and the duration was 116 min (SD± 23). No correlation was obtained between patients height, BH dose and block duration. 1 patient presented bradycardia. No general anesthesia was necessary. DISCUSSION: The USA with a low dose of HB and ITF it's safe to developed OAS. Only 11 min were necessary to obtain a good SB and MB.

Clinical study of using spectral CT at the minimal dose of contrast medium in cranial CTA / 中国生化药物杂志

Objective To investigate the minimum dose of contrast medium when using spectral CT in cranial CTA. Methods Three groups of patients were required to undergo head CTA examination because of their condition,but different doses of contrast agents were injected.Among them,group 30 mL, group B, group 40mL, group C and group 50 mL were A. Results In group A,the lowest rate of excellent image (23.33%), B group, C group had higher rate of excellent image (93.33%, 96.67%), comparison of the data P<0.05; C group the highest rate of adverse reaction of contrast agent (P<0.05),data comparison P<0.05, A group, B group significantly adverse reactions of contrast agent there is no difference between the situation (P>0.05). Conclusion The use of 40 mL iodide contrast medium in the procedure of cranial CTA examination is effective and safe.

Clinical study of using spectral CT at the minimal dose of contrast medium in cranial CTA / 中国生化药物杂志

Objective To investigate the minimum dose of contrast medium when using spectral CT in cranial CTA. Methods Three groups of patients were required to undergo head CTA examination because of their condition,but different doses of contrast agents were injected.Among them,group 30 mL, group B, group 40mL, group C and group 50 mL were A. Results In group A,the lowest rate of excellent image (23.33%), B group, C group had higher rate of excellent image (93.33%, 96.67%), comparison of the data P<0.05; C group the highest rate of adverse reaction of contrast agent (P<0.05),data comparison P<0.05, A group, B group significantly adverse reactions of contrast agent there is no difference between the situation (P>0.05). Conclusion The use of 40 mL iodide contrast medium in the procedure of cranial CTA examination is effective and safe.

Minimal-dose computed tomography is superior to chest x-ray for the follow-up and treatment of patients with resected lung cancer.

OBJECTIVES: A minimal-dose computed tomography scan of the thorax (MnDCT) delivers a radiation dose comparable with a chest x-ray (CXR). We hypothesized that in patients with completely resected lung cancer, surveillance with MnDCT, when compared with CXR, leads to earlier detection and a higher rate of treatment of new or recurrent lung cancer. METHODS: After lung cancer resection, patients prospectively were enrolled for surveillance with MnDCT and CXR at 3, 6, 12, 18, 24, 36, 48, and 60 months. Images were interpreted by different blinded radiologists. When new or recurrent cancer was suspected, standard-dose CT and/or a tissue biopsy were performed for confirmation. RESULTS: Between 2007 and 2012, 271 patients were included and 1137 pairs of CXR and MnDCT were analyzed. MnDCT was more sensitive (94% vs 21%; P < .0001) and had a higher negative predictive value (99% vs 96%; P = .007) than CXR for the diagnosis of new or recurrent lung cancer. The prevalence of new or recurrent lung cancer was 23.2% (63 of 271), of whom 78% (49 of 63) had asymptomatic disease. The majority of asymptomatic patients (75%; 37 of 49) were treated with curative intent and had a median survival of 69 months. The remainder of patients received palliative treatment (24%; 12 of 49) and had a median survival of 25 months (P < .0001). CONCLUSIONS: After curative resection of lung cancer, MnDCT is superior to CXR for the detection of new or recurrent lung cancer. The majority of new or recurrent cancer was detected by MnDCT at an asymptomatic phase, allowing for curative treatment, leading to a long survival.