Acute effects of different external compression with blood flow restriction on force-velocity profile during squat and bench press exercises.

The aim was to compare the acute effects of bench press (BP) and squat (SQ) exercises with blood flow restriction (BFR) (40%, 60%, 80% and 100% of the complete arterial occlusion pressure (AOP)) and without BFR (CON) on the mean propulsive (VelMED) and maximum (VelMAX) bar velocity. Fourteen healthy, physically active males (age, 23.6 ± 4.1 years; height, 1.85 ± 0.11 m; body weight 85.4 ± 4.1 kg) took part in the study. There was one set for each testing condition (CON, 40%, 60%, 80% and 100%) with 6 repetitions for BP and 6 repetitions for SQ, at 60% of 1RM, and 3 minutes of recovery between sets. The results showed statistically significant differences of the sets with 80% BFR vs. CON (mean difference [MD] = 0.035 m · s-1, p < 0.05, ES = 0.52 [1.02-0.03]) and 100% BFR sets vs. CON (MD = 0.074, p < 0.001, ES = 1.08 [1.79-0.38]) for BP. In the SQ exercise, statistically significant differences were found between 100% BFR vs. CON (DM = 0.031 m · s-1, p < 0.05), vs. 100% BFR 40% (MD = 0.04 m · s-1, p < 0.05). Trend analysis showed a statistically significant linear trend (F[1,9] = 34.9, p < 0.001, F[1,13] = 27.32, p < 0.001) for the VelMED in relation to the different levels of BFR. In conclusion, our results showed that BFR levels above ˜80% AOP (BP) and ˜100% AOP (SQ) produce a VelMED improvement at 60% 1RM.

Combining varenicline and nicotine patches: a randomized controlled trial study in smoking cessation.

BACKGROUND: Some smokers may benefit from a therapy that combines different nicotine replacement therapies (NRT) or drugs with different mechanisms of action.The aim of this study was to determine the efficacy of the combined therapy of varenicline and nicotine patches versus varenicline monotherapy. METHODS: Three hundred forty-one smokers who smoked 20 or more cigarettes per day were recruited from a smoking cessation clinic between February 2012 and June 2013. The participants were randomized to receive a varenicline plus nicotine patch of 21 mg every 24 hours (170) or varenicline plus a placebo patch (171). All of the smokers received a standard 12-week course of varenicline and an 11-week course of either the placebo patch or the active patch after the target quit day. Both groups received behavioral support. The primary outcome was continuous abstinence for weeks 2 through 12 confirmed by exhaled levels of carbon monoxide. Post hoc subgroup analyses were performed to evaluate the treatment effects for a specific endpoint in subgroups of smokers. RESULTS: The combination of the nicotine patch with varenicline was not associated with higher rates of continuous abstinence at 12 weeks (39.1% versus 31.8%; odds ratio (OR) 1.24; 95% confidence interval (CI) 0.8 to 2.6) and 24 weeks (32.8% versus 28.2%; OR 1.17; 95% CI 0.4 to 1.9). When participants were analyzed by subgroups according to cigarette consumption, the abstinence rates among smokers who smoked more than 29 cigarettes per day at 12 weeks (OR 1.39; 95% CI 1.2 to 2.5) and 24 weeks (OR 1.46; 95% CI 1.2 to 2.8) were significantly higher in the combination group. Other post hoc analyses based on level of dependence and previous quit attempts did not show subgroup differences. No differences between the groups for the reported adverse events were observed (χ2 value 0.07; P 0.79). CONCLUSIONS: The combination of varenicline with the nicotine patch does not improve abstinence rates at 12 and 24 weeks compared with varenicline used as monotherapy when all smokers were analyzed as a whole, independent of consumption level. TRIAL REGISTRATION: This study is registered at clinicaltrial.gov (NCT01538394).

Effects of Blood flow Restriction and Load on Mean Propulsive Velocity and Subjective Perceived Exertion During Squat and Bench Press Exercises.

BACKGROUND: The aim of this study was to determine the influence of different percentages of blood flow restriction (BFR) and loads on mean propulsive velocity (MPV) and subjective perceived exertion during squat (SQ) and bench press (BP) exercises. HYPOTHESIS: Higher percentages of BFR will positively affect dependent variables, increasing MPV and reducing perceived exertion. STUDY DESIGN: Cross-sectional study. LEVEL OF EVIDENCE: Level 3. METHODS: Eight healthy young male athletes took part. Two sets of 6 repetitions at 70% 1-repetition maximum (1RM), 2 sets of 4 repetitions at 80% 1RM, and 2 sets of 2 repetitions at 90% 1RM were performed randomly; 5-minute recoveries were applied in all sets. The varying arterial occlusion pressure (AOP) applied randomly was 0% (Control [CON]), 80%, and 100%. RESULTS: No statistically significant differences in MPV were found during the BP exercise at any percentage of BFR at any percentage 1RM. During the SQ exercise, MPV results showed statistically significant increases of 5.46% (P = 0.04; ηp2 = 0.31) between CON and 100% AOP at 90% 1RM. The perceived exertion results for the BP exercise showed statistically significant reductions of -8.66% (P < 0.01; ηp2 = 0.06) between CON and 100% AOP at 90% 1RM. During the SQ exercise, the perceived exertion results showed significant reductions of -10.04% (P = 0.04; ηp2 = 0.40) between CON and 100% AOP at 80% 1RM; -5.47% (P = 0.02; ηp2 = 0.48) between CON and 80% AOP at 90% 1RM; and -11.83% (P < 0.01; ηp2 = 0.66) between CON and 100% AOP at 90% 1RM. CONCLUSION: BFR percentages ~100% AOP at 90% 1RM improved acutely MPV (only in SQ exercises) and reduced acutely perceived exertion (in both exercises). These findings are important to consider when prescribing resistance training for healthy male athletes.

A multicentre randomized trial of combined individual and telephone counselling for smoking cessation.

OBJECTIVE: The present study assessed the effectiveness of smoking cessation programs combining individual and telephone counselling, compared to individual or telephone counselling alone. METHOD: A randomized, multicentre, open-label trial was performed between January 2009 and July 2011 at six smoking cessation clinics in Spain. Of 772 smokers assessed for eligibility, 600 (77%) met inclusion criteria and were randomized. Smokers were randomized to receive individual counselling, combined telephone and individual counselling, or telephone counselling. The primary outcome was biochemically validated continuous abstinence at 52 weeks. RESULTS: The 52-week abstinence rate was significantly lower in the telephone group compared to the combined group (20.1% vs. 29.0%; OR, 1.32; 95% CI, 1.1-2.7) and to the individual counselling group (20.1% vs. 27.9%; OR, 1.37; 95% CI, 1.0-2.8). The 52-week abstinence rates were not significantly higher in the combined group than the individual group (OR, 0.97; 95% CI, 0.7-1.4). CONCLUSION: Individual counselling and combined individual and telephone counselling were associated with higher 52-week abstinence rates than telephone counselling alone. A combined approach may be highly useful in the clinical treatment of smokers, as it involves less clinic visits than individual counselling alone, thus reducing the program cost, and it increases patient compliance compared to telephone counselling alone.

Food groups and nutrient intake and risk of colorectal cancer: a hospital-based case-control study in Spain.

Although evidence supports that colorectal cancer (CRC) has an environmental etiology, the potential influence of diet appears to be one of the most important components. We studied the relation between food groups and nutrient intake and the risk of CRC. A hospital-based case-control study was conducted in Spain between 2007 and 2009. The authors matched 245 patients with incident histologically confirmed CRC by age, gender, and date of admission with 490 controls. Information about nutrient intake was gathered by using a semiquantitative frequency food questionnaire. Univariate analysis was done with individual food items. Odds ratios (ORs) for consecutive tertiles of nutrient intake were computed after allowance for sociodemographic variables and consumption of food groups. Vitamin B6 (OR: 0.26), vitamin D (OR: 0.45), vitamin E (OR: 0.42), polyunsaturated fatty acids (OR: 0.57), and fiber (OR: 0.40) were inversely associated with CRC, whereas carbohydrates (OR: 1.82) were significantly associated with CRC risk for the upper tertile. In multivariate analysis adjusting for major covariables (energy, age, and gender), vitamin D (OR:0.45), vitamin E (OR:0.36), and fiber (OR:0.46) remained associated with CRC. Data suggest that the etiology of colorectal cancer is not due to lifestyle and dietary patterns being important the effect of single nutrients.

Gambling disorder seeking treatment patients and tobacco use in relation to clinical profiles.

OBJECTIVES: Tobacco smoking and gambling disorder (GD) often co-occur. However, few studies have assessed the extent to which cigarette smoking may serve to classify and/or better define GD behaviour profiles. METHODS: Among a large sample of n = 3,652 consecutive treatment-seeking patients with GD (91% men). Smokers were compared to non-smokers across different sociodemographic, clinical, psychopathological and personality variables. The effect sizes for the means and the proportion differences between the groups were estimated. An evaluation of the smoking changes over the last 15 years was also performed. RESULTS: From the total sample, 62.4% of gamblers reported tobacco use. A decreasing linear trend in tobacco use was observed within the studied period, women having a more irregular pattern. The use of tobacco was linked to the use of alcohol and other illegal drugs. Gamblers who smoke, as compared to those who don't, presented lower education levels, lower social position indexes and active employment. They were younger, with an earlier age of onset, shorter duration of the gambling behavior, higher GD severity, more psychological symptoms, higher scores in novelty seeking and lower scores in reward dependence, self-directedness and self-transcendence. CONCLUSIONS: Gamblers seeking treatment who smoke display particular social, clinical, psychological, temperamental and character features different from non-smoking gamblers, suggesting that the presence or absence of comorbid smoking condition in GD should always be considered when developing an optimal treatment, as gamblers who smoke might need treatment strategies different from non-smoking gamblers.

Periodontal disease as a risk factor for adverse pregnancy outcomes: a prospective cohort study.

AIM: The aim of this study was to determine the association between periodontitis and the incidence of preterm birth (PB), low birth weight (LBW) and preterm low birth weight (PLBW) MATERIAL AND METHODS: One thousand and ninety-six women were enrolled. Periodontal data, pregnancy outcome variables and information on other factors that may influence adverse pregnancy outcomes were collected. Data were analysed using a logistic regression model. RESULTS: The incidence of PB and LBW was 6.6% and 6.0%, respectively. The incidence of PLBW was 3.3%. PB was related to mother's age, systemic diseases, onset of prenatal care, previous PBs, complications of pregnancy, type of delivery, the presence of untreated caries and the presence of periodontitis (odds ratio 1.77, 95% confidence interval: 1.08-2.88). LBW was related to mother's smoking habits, ethnicity, systemic diseases, previous LBW babies, complications of pregnancy and type of delivery. PLBW was related to mother's age, onset of prenatal care, systemic diseases, previous LBW babies, complications of pregnancy and type of delivery. CONCLUSIONS: The factors involved in many cases of adverse pregnancy outcomes have still not being identified, although systemic infections may play a role. This study found a modest association between periodontitis and PB. Further research is required to establish whether periodontitis is a risk factor for PB and/or LBW.

Relationship of altitude mountain sickness and smoking: a Catalan traveller's cohort study.

OBJECTIVES: The aim of this study is to analyse the relationship between smoking and altitude mountain sickness in a cohort of travellers to 2500 metres above sea level (masl) or higher. SETTING: Travel Health Clinic at the Hospital Universitari de Bellvitge, in Barcelona, Spain. PARTICIPANTS: A total of 302 adults seeking medical advice at the travel clinic, between July 2012 and August 2014, before travelling to 2500 masl or above, who agreed to participate in the study and to be contacted after the trip were included. Individuals who met the following criteria were excluded: younger than 18 years old, taking carbonic anhydrase inhibitors for chronic use, undergoing treatment with systemic corticosteroids and taking any medication that might prevent or treat altitude mountain sickness (AMS) prior to or during the trip. The majority of participants were women (n=156, 51.7%). The mean age was 37.7 years (SD 12.3). The studied cohort included 74 smokers (24.5%), 158 (52.3%) non-smokers and 70 (23.2%) ex-smokers. No statistical differences were observed between different sociodemographic characteristics, constitutional symptoms or drug use and smoking status. OUTCOMES: The main outcome was the development of AMS, which was defined according to the Lake Louise AMS criteria. RESULTS: AMS, according to the Lake Louise score, was significantly lower in smokers; the value was 14.9%, 95% CI (6.8 to 23.0%) in smokers and 29.4%, 95% CI (23.5 to 35.3%) in non-smokers with an adjusted OR of 0.54, 95% CI (0.31 to 0.97) independent of gender, age and maximum altitude reached. CONCLUSIONS: These results suggest that smoking could reduce the risk of AMS in non-acclimated individuals. Further studies should be performed in larger cohorts of travellers to confirm these results. Despite the results, smoking must be strongly discouraged because it greatly increases the risk of cardiorespiratory diseases, cancer and other diseases.

Comparative cost of selective screening to prevent transmission of methicillin-resistant Staphylococcus aureus (MRSA), compared with the attributable costs of MRSA infection.

The annual cost of a screening program to detect methicillin-resistant Staphylococcus aureus (MRSA) in a teaching hospital in Spain was 10,261 Euro. The average cost per MRSA infection was 2,730 Euro; therefore, the cost of the program would be covered if it only prevented 4 infections per year (11% of the total number of MRSA infections at our hospital).

Biases and adjustments in nutritional assessments from dietary questionnaires.

In nutritional epidemiology, it is essential to use Food Consumption Assessment Methods that have been validated and accepted by the international community for estimating food consumption of individuals and populations. This assessment must be made with the highest quality possible so as to avoid, as far as possible, sources of error and confusion in the processes. The qualities that are required in a measurement method are validity and accuracy; validity being the main factor. Lack of validity produces biases, or systematic errors. These can reside in the process of subject selection, or processes of information gathering where the lack of accuracy produces random errors. For many nutrients, the intra-individual variances are due to many factors such as day-of-the-week or season, and could create problems in the data analyses. Adjustments are needed to minimize these effects. Confounding factors may over- or under-state the real magnitude of the observed association, or even alter the direction of the real association. Total energy intake can be a confounding variable when studying a relationship between nutrient intake and disease risk. To control for this effect several approximations are proposed such as nutrient densities, standard multivariate models and the nutrient residual model.

En la epidemiología nutricional es esencial la utilización de los Métodos Valoración del Consumo Alimentario validados y aceptados por la comunidad internacional para estimar el consumo alimentario de los individuos y grupos de población. Esta estimación debe hacerse con la mayor calidad posible, evitando, en la medida de lo posible, las fuentes de error y confusión en la medida del consumo alimentario. Las cualidades que otorgan calidad a un método de medida son la validez y la precisión, siendo la validez la principal característica. La falta de validez produce sesgos o errores sistemáticos, los cuales pueden ser en el proceso de selección de los sujetos o en el proceso de obtención de la información; y la falta de precisión produce errores aleatorios. Para muchos nutrientes, las variaciones intra-individuales debidas a muchos factores como el día de la semana o la estación del año, podrían crear problemas en los análisis de datos. Para minimizar este efecto se deben realizarse algunos ajustes en los análisis. Los factores de confusión pueden exagerar o subestimar la verdadera magnitud de la asociación o incluso alterar la dirección de la asociación. El consumo total de energía puede ser una variable de confusión en el estudio de la relación entre la ingesta de nutrientes y el riesgo de enfermedad. Para controlar este efecto se proponen varias aproximaciones: la densidad de nutrientes, modelo multivariado estándar y el modelo residual de nutrientes.