Does fitness attenuate the relationship between changes in sitting time and health-related quality of life over time in community-dwelling older adults? Evidence from the EXERNET multicenter longitudinal study.

OBJECTIVE: To assess the relationship between fitness levels and components, sitting time and health-related quality of life (HRQoL), over time among community-dwelling older adults. METHODS: Three different sitting trajectories were calculated: (i) no change; (ii) decrease; and (iii) increase in ST, between baseline and follow-up. Fitness was assessed using the aerobic capacity, upper and lower limb strength, and total fitness. Participants were classified into higher (75th percentile or above) or lower (below 75th percentile) fitness levels, using the fitness tests. HRQoL scores at follow-up were compared to the three different sitting time trajectories within and across both the higher and the lower fitness groups for each of the three fitness indexes. RESULTS: Greater HRQoL scores were observed in those participants that decreased their ST as compared with those increasing their sitting time over time for participants classified in the lower end of their aerobic capacity or total fitness index. No differences were detected in HRQoL scores in people classified in the higher fitness level group for any of the fitness indexes. Participants that increased or did not change their sitting time and who were classified in the higher fitness end of aerobic capacity and total fitness index self-reported higher HRQoL scores when compared with those in the lower fitness end. CONCLUSION: Increased sitting time over time is associated with poorer HRQoL in older adults. Higher fitness levels could help attenuate the negative impact of sitting over time.

Time-course effects of aerobic interval training and detraining in patients with metabolic syndrome.

BACKGROUND AND AIMS: Exercise training can improve health of patients with metabolic syndrome (MetS). However, which MetS factors are most responsive to exercise training remains unclear. We studied the time-course of changes in MetS factors in response to training and detraining. METHODS AND RESULTS: Forty eight MetS patients (52 ± 8.8 yrs old; 33 ± 4 BMI) underwent 4 months (3 days/week) of supervised aerobic interval training (AIT) program. After 1 month of training, there were progressive increases in high density lipoprotein cholesterol (HDL-c) and reductions in waist circumference and blood pressure (12 ± 3, -3.9 ± 0.4, and -12 ± 1%, respectively after 4 months; all P < 0.05). However, fasting plasma concentration of triglycerides and glucose were not reduced by training. Insulin sensitivity (HOMA), cardiorespiratory fitness (VO2peak) and exercise maximal fat oxidation (FOMAx) also progressively improved with training (-17 ± 5; 21 ± 2 and 31 ± 8%, respectively, after 4 months; all P < 0.05). Vastus lateralis samples from seven subjects revealed that mitochondrial O2 flux was markedly increased with training (71 ± 11%) due to increased mitochondrial content. After 1 month of detraining, the training-induced improvements in waist circumference and blood pressure were maintained. HDL-c and VO2peak returned to the values found after 1-2 months of training while HOMA and FOMAx returned to pre-training values. CONCLUSIONS: The health related variables most responsive to aerobic interval training in MetS patients are waist circumference, blood pressure and the muscle and systemic adaptations to consume oxygen and fat. However, the latter reverse with detraining while blood pressure and waist circumference are persistent to one month of detraining.

Influence of hard vs. soft ground surfaces on bone accretion in prepubertal footballers.

Information regarding osteogenic effects of physical activity performed on different playing surfaces is scarce. A total of 42 children (9.2±0.2 years, Tanner stages I-II) participated in this study. 14 were playing on artificial turf soft ground (SG), 14 on a natural non-grass hard ground (HG) and 14 were assigned to the sedentary control group (C). Whole body and hip scans (dual energy X-ray absorptiometry), anthropometric variables (weight and height) and physical fitness (VO2max) were determined in all participants. Bone mineral content (BMC) values were higher in the SG group compared to the C group at the legs (209.75±5.11 g vs. 187.42±5.14 g, respectively), pelvis (122.72±4.27 g vs. 98.58±4.29 g respectively) and whole-body level (1 126.1±22.81 g vs. 1 035.34±22.92 g, respectively). The hard ground (HG) group also showed higher values in the majority of BMC variables compared to the C group. Additionally, bone mineral density (BMD) was significantly higher at all sites of the hip in both active groups compared to control (P<0.05). No differences between HG and SG were found. In summary, similar bone mass accretion is obtained by prepubescent footballers independently of the surface on which they practice football.

La leche por bandera en Granada. Evolución de las nodrizas desde la plaza de las pasiegas hasta el banco de leche del hospital materno infantil de Granada / Milk by flag in Granada. Evolution of the wet nurses from Pasiegas square to the Maternal Human Milk Bank of the Maternity Hospital in Granada

Cuando pensamos en nodriza, las dos palabras que se vienen a la cabeza son leche materna y altruismo. Dos vocablos que han estado ligados a ellas y que hoy, en el siglo XXI, aún continúan. Las primeras nodrizas hicieron de esto una forma de trabajo, no estaba remunerado y para la clase alta era una forma de librarse del cuidado y crianza de sus hijos. Para las nodrizas supuso la incorporación al mundo laboral [Fragmento de texto] (AU)

Higher bone mass in prepubertal and peripubertal female footballers.

OBJECTIVES: The main aim of this study was to compare the bone mass of female football players with controls of different pubertal stages. METHODS: Sixty five girls aged 8-14 years (10.14 ± 0.1, Tanner stages I-IV) participated in the study. Twenty participants were prepubertal (10 prepubertal control) and 45 peripubertal (15 peripubertal control). All footballers trained two days per week while the control group did not perform regular physical activity outside of school. Body composition was assessed by Dual-energy X-ray absorptiometry. Analysis of covariance was performed to evaluate differences in lean and bone masses. RESULTS: Significant differences in lower-body extremities lean mass (LLM) between peripubertal groups were found (P < .05). Additionally, prepubertal footballers showed higher values of bone mineral content (BMC) at the femoral neck (P < .05) while peripubertal footballers exhibited enhanced BMC at the whole-body, trochanter and Wards triangle area. Bone mineral density (BMD) was higher in footballers compared to their non-active peers at the femoral neck and intertrochanter (P < .05, respectively) while in the peripubertal footballers higher BMD values were found in almost all of the studied body sites. CONCLUSION: Female footballers showed higher bone and lean masses compared to control counterparts; these differences are already detectable at prepubertal ages and more consistent after pubertal spurt.

The Spanish version of the Three Factor Eating Questionnaire-R21 for children and adolescents (TFEQ-R21C): Psychometric analysis and relationships with body composition and fitness variables.

OBJECTIVE: The main purpose of the present study is to assess the factor structure and reliability of the Spanish version of the 21-item Three Factor Eating Questionnaire (TFEQ-R21C) in children and adolescents and to analyze the relationships between eating behaviors, body composition and cardiovascular fitness. SUBJECTS: A total of 192 children and adolescents took part in this study (89 boys and 103 girls; aged from 8.8 to 16.8years old and with body mass index (BMI) ranging from 13.2 to 41.1kg/m(2)). None of them had either a history of psychological or eating disorders. MEASUREMENTS: Body composition (dual-energy X-ray absorptiometry-DXA), anthropometrics (body mass, height and BMI), cardiovascular fitness (cyclo-ergometer incremental test) and eating behaviors (TFEQ-R21C) were determined in all participants. RESULTS: The confirmatory factor analysis corroborated the same three factors of the original TFEQ-R21: Uncontrolled Eating (UE), Emotional Eating (EE) and Cognitive Restraint (CR). The internal-consistency reliability (Cronbach's alpha coefficient) for the questionnaire was 0.73. Significant differences were found in BMI (F2,189=3.50, p=0.032) and total fat mass (TFM) (F2,189=3.60, p=0.029) between tertiles of the CR scale (children who had the lowest scores, also had lower BMI and fat mass). Cardiovascular fitness (measured by relative VO2 peak) differs depending on the UE and CR scores. The "healthy" group (those who were normal-weight and had also the highest relative VO2 peak) showed a significant lower CR (F3,160=3.07, p=0.030) and higher UE (F3,160=3.86, p=0.011) than the "unhealthy" group (those who were neither normal-weight nor had adequate relative VO2 peak). CONCLUSIONS: According to the psychometric analysis of the questionnaire, the TFEQ-R21C is a valid and useful tool to assess eating behaviors in Spanish child population. Further research is necessary to understand the links between eating behaviors and other health-related behaviors such as physical activity time or cardiovascular fitness.

Effect of muscular ultrasound stimulation on power spectrum electromyography during a strengthening training.

The purpose of this study is to describe the electromyographic (EMG) power spectral evolution during a muscle strengthening training based on ultrasound stimulation applied to the right rectus femoris muscle simultaneously with its maximum voluntary isometric contraction (MVIC) in ten healthy subjects. From the surface EMG of rectus femoris the Zero Crossing (ZC) and integrated EMG (IEMG) were calculated. The Mean Power Frequency (MPF) and Median Frequency (MF) from the EMG power spectrum were obtained using a maximum entropy method. An Analysis of Variance (ANOVA) for repeated measures showed significant changes for IEMG and ZC throughout sessions and for MPF, MF and ZC between the pretest and posttest. Immediate increases in MPF, MF and ZC were observed (paired t-test, p < 0.05) after training and an increment of IEMG during sessions (one-way ANOVA, p = 0.01). The ultrasound pulsed stimulation applied simultaneously with a MVIC produced the development of the muscle force. The mechanism of action of this application could be the mechanical effect, compression and rarefaction, produced by the ultrasound stimulation during the muscle contraction process.

Spectral electromyographic changes during a muscular strengthening training based on electrical stimulation.

The aim of this study is to describe the effects of neuromuscular electrical stimulation on electromyographic power spectrum evolution through a program of muscle strengthening. Ten healthy subjects received electrical stimulation of the quadriceps femoris muscle. Surface EMG was obtained from rectus femoris during maximum voluntary isometric contractions of quadriceps. Directly from EMG the Zero Crossing Rate and Root Mean Square (RMS) were calculated. Afterwards, the Mean Power Frequency and Median Frequency from EMG power spectrum were obtained using the Maximum Entropy method to estimate the spectrum. An analysis of variance for repeated measures revealed a statistical significance for RMS through the sessions and for spectral shifts towards higher frequencies between, before and after electrical stimulation. The evolution of power spectrum through sessions showed a curvilinear evolution, first decreasing towards lower frequencies and then increasing. These results suggest that electrical stimulation produces immediate changes on the motor unit: increasing the recruitment number and action potential velocity and a selective recruitment of type II fibres. During the strengthening program sessions two main phases were detected: the appearance and recovery from fatigue.

[Electronystagmography of sudden head impulses (head-only impulsive rotational testing, head thrust test, head impulse test)]. / Registro electronistagmográfico del test de movimientos cefálicos bruscos (head-only impulsive rotational testing, head thrust test, head impulse test).

The basis of the head-thrust test is when a head thrust is done in the horizontal plane, the ipsilateral semicircular canal is the only which gets the gaze stabilization, being the other HSC completely inhibited. In this paper are investigated the ENG records according the test and analyzed the main parameters obtained. As conclusion we admit that the main parameters are the compensating ocular movements amplitude and their latencies.

[Caloric surface and assessment of the caloric bithermal test. Toward an intelligent system of vestibular diagnosis]. / La superficie calórica en la valoración de la prueba calórica bitérmica: hacia un sistema inteligente de diagnóstico vestibular.

The theoretical basis for bithermal caloric test assessment by means of caloric surfaces is described. This system supports a computer program for the automatic appraisal of the test, as a first step in the development of our intelligent system for vestibular diagnosis.

[Head-thrust test: its validity as a diagnostic clinical test]. / El test de movimientos cefálicos bruscos (head-thrust test): validación para su uso como prueba diagnóstica clínica.

The head-thrust test is presented as an ideal test to investigate the horizontal vestibulo-ocular reflex. We review its theoretical basis, and assess it as a diagnostic test with a 22 patient series. Its specificity accounts for 100% and the sensibility for 54%. Would this test substitute in the future the caloric test?

[Reading test as a qualitative method for evaluating the vestibulo-ocular reflex]. / El test de lectura como método de valoración cualitativa del reflejo vestibuloocular.

In the reading test the patient reads a text while his or her head is passively moved from one side to another with a frequency over 2 Hz. The vestibulo-ocular reflex (VOR) should stabilize the patient's gaze if it is performing adequately, allowing him or her to read well. Reading becomes impossible if the VOR is defective. We tested this method by assessing VOR in a 30-patient series by means of VAT and a previous reading-test score, and we compared the results of both groups. Next, the test was clinically validated with the bithermal caloric test. There were significant differences in ocular asymmetry between normal and strongly positive groups. The sensitivity, specificity, and positive and negative predictive values validated the reading testing as clinically useful.

[The head-thrust test (HTT): physiopathological considerations and its clinical use in daily practice]. / El test de movimientos cefálicos bruscos [head-thrust test (HTT)]: consideraciones fisiopatológicas y utilidad en la clínica diaria.

The basis of the head-thrust test is that when a head thrust is made in the horizontal plane, the ipsilateral semicircular channel (SCC) shows gaze stabilization because the homolateral SCC is completely inhibited. This test was studied by electronystagmography and the main parameters, the amplitude and latency of the compensatory ocular movements, were analyzed. The sensitivity, specificity, and positive and negative predictive value of this test were estimated in a series of 22 patients. The values were, respectively, 54, 100, 100 and 68%.

[Bimastoid leads and bilateral stimulation in the recording of auditory-evoked brain-stem potentials]. / La derivación bimastoidea y estimulación bilateral en el registro de potenciales evocados auditivos de tronco cerebral.

The recording of auditory brain stem potentials (ABR) with bimastoid leads and bilateral stimulation makes it possible to evaluate relative cochlear function and the type of hearing loss. The theoretical background for this technique and the results obtained in patients with disease of the internal-middle ear, cochlea, and auditory nerve are discussed.

[Star-gait measured by craniocorpography: pattenrs, classification, physiopathological considerations and clinical utility]. / La marcha en estrella registrada mediante craneocorpografía: patrones, clasificación, consideraciones fisiopatológicas y utilidad clínica.

The results of craniocorpographic recordings in the Babinski-Weil test are discussed, focusing on the star-shaped variant. The variants of star-shaped gait are defined as posterior, centered, advanced, forward, extreme, and lateral. In 22 healthy individuals and 60 patients, star-shaped gait was the most common deviation. Extreme star-shaped gait was the most frequent variant in the healthy subjects and the backward variant was the most frequent in the patient group.

[Volume and demand of rheumatologic problems and their management at a primary health care center]. / Estudio del volumen y la demanda de problemas reumatológicos y su manejo en un centro de atención primaria.

The present study was carried out as a part of the elaboration process of the Program of Rheumatologic Diseases of the health center of Chapela. The following rates are reported: the volume of patients affected by these problems (14.5%), the generated care demand (6.9% of the overall demand), the age and sex distribution, their importance as a reason of disability (14.4% of the overall number of sick leaves), and the different specific diagnoses. To evaluate how these patients were managed by the team, a series of indicators were used, such as the number of identified patients, the quality of the documentation, the types of complementary investigations, the referral of patients to the secondary level, and the adequacy of therapies. As conclusions, a significant volume of rheumatologic consultations and work disabilities was found, with a high use rate of radiological studies and a low use rate of laboratory investigations, the use of basically NSAI drugs in the therapy, and the need for a specifically oriented clinical record to be used in the diagnosis and follow up of these conditions.

[How are the patients informed at a hospital emergency service?]. / Cómo se informa a los pacientes en un servicio de urgencias hospitalario?

OBJECTIVE: To evaluate the clarity and efficacy of the information given to patients by doctors, in the hospital emergency ward (HEW) and the influence of accompanying people on such information. DESIGN: Descriptive transverse study. SETTING: HEW of the Hospital General of Segovia. PATIENTS AND OTHER PARTICIPANTS: 171 patients seen at the HEW between July and September of 1993. MEASUREMENTS AND MAIN RESULTS: An oral questionnaire consisting on 15 items including: age, sex and sociocultural profile of the patient, presence of a companion, knowledge the doctor's identity, oral information recived during the stay and oral and written recommendations at the time of discharge, was used. The report of discharge delivered to the patient was used for contrast. Only 20 patients (11.7%) knew the name of the doctor who attended them; a statistically significant difference (p > 0.01) was found in favour of those who were accompanied. In spite of the fact that 97.6% of the patients said that they had received a clear information and that 88.9% of them did referred to have no doubts, only 71.9% of them were able to repeat correctly the treatment recommended at the time of discharge. A 50% of the patients were able to read and understand the written report, while 19% of them did not understand it and another 20% considered it illegible. CONCLUSIONS: In order to guarantee the patient's compliance with recommendations given at the time of discharge of a HEW, it is necessary to improve oral and written information given to them, relying on the presence of a companion and checking their assimilation.

[Alport-Perkoff's syndrome (two cases report)]. / Síndrome de Alport-Perkoff (a propósito de dos observaciones

Two patients affected with Alport's syndrome belonging respectively to two families with a high incidence of urinary, auditive and ocular symtoms, are described. The most relevant features are commented pointing out that Alport's syndrome could be a structural malformation of the whole or only one part of a type of colagen probably specific of the basal membrane of the glomerulus which could be more easily affected forming toxic metabolites. Finally a reference to the histologic study is made.