Are Self-Selected Intervals as Effective as Fixed Intervals in Controlling Acute Responses in High-Intensity Interval Resistance Training?

Physical conditioning programs often apply high-intensity resistance training (HIRT), but there is a lack of research investigating the effects of using fixed or self-selected resting intervals between exercises on the performance, relative intensity, and affective perception during this modality of training. This study compared fixed versus self-selected rest intervals in HIRT sessions on cardiorespiratory responses, number of repetitions, and enjoyment perception in trained young men. Sixteen trained males (27.1 ± 3.9 years; 56.6 ± 7.5 mL.kg-1.min-1) performed HIRT circuits with 30-s and self-selected recovery interval. The duration of resting intervals was longer in HIRT performed with fixed than self-selected intervals (14.04 ± 5.82 s; p < 0.0001; ES = 3.2). Both sessions elicited similar relative HRR (79.4 ± 6.2 % vs. 81.6 ± 4.2 %; p = 0.14), VO2R (43.0 ± 12.2% vs. 47.7 ± 9.6%; p = 0.10), and enjoyment reflected by scores in the PACES questionnaire (107.9 ± 15.1 vs. 109.2 ± 12.8; p = 0.65). The total number of repetitions (403.4 ± 45.5 vs. 353.1 ± 27.4; p < 0.01, ES = 1.3) and caloric expenditure (154.4 ± 28.6 kcal vs. 121.4 ± 21.6 kcal; p < 0.001, ES = 0.13) were greater in HIRT performed with fixed vs. self-selected intervals. In conclusion, HIRT performed with fixed and self-selected rest intervals elicited similar relative intensity and enjoyment perception. However, the number of repetitions and caloric expenditure were greater in sessions performed with fixed 30-s.

Self-selected or fixed: is there an optimal rest interval for controlling intensity in high-intensity interval resistance training?

PURPOSE

This study investigated the effects of different rest interval strategies during high-intensity interval resistance training (HIRT) on cardiorespiratory, perceptual, and enjoyment responses among trained young men.

METHODS

Sixteen men experienced with HIRT underwent cardiopulmonary exercise testing and were familiarized with the exercises and HIRT protocol. On the subsequent three visits, interspaced 48-72 h, participants performed HIRT sessions with different rest intervals in a randomized order: 10 s and 30 s fixed rest intervals (FRI-10 and FRI-30), and self-selected rest interval (SSRI). Oxygen uptake (VO2), heart rate (HR), and recovery perception (Total Quality Recovery Scale) were measured during HIRT, while enjoyment responses (Physical Activity Enjoyment Scale) were assessed immediately after the sessions.

RESULTS

The VO2 during exercise was greater in FRI-10 than FRI-30 (55% VO2max and 47% VO2max, respectively, p = 0.01), while no difference occurred between SSRI and bouts performed with fixed intervals (52% VO2max vs. FRI, p > 0.05). HR, excess post-exercise oxygen consumption (EPOC), recovery perception, and enjoyment responses were similar across conditions (p > 0.05).

CONCLUSION

Exercise intensity was not affected by the rest interval strategy. High exercise intensity was maintained in sessions performed with FRI or SSRI, without negative repercussions on the duration of training sessions and enjoyment responses after exercise sessions.

Influence of HIIRT With Fixed and Self-Selected Recovery Intervals on Physiological, Affective, and Enjoyment Responses

Purpose: Recovery-interval strategies may influence physiological and psychological responses during highintensity interval resistance training (HIIRT). This study compared the intensity, performance, and psychological outcomes during all-out effort HIIRT performed with fixed (FRI) and self-selected (SSRI) recovery intervals. Methods: Sixteen trained males (27.2 ± 4.1 years; 84.5 ± 8.9 kg; 55.8 ± 7.1 mL.kg-1.min-1) performed HIIRT bouts interspersed with FRI (10 s) and SSRI (15.3 ± 7.9 s). Results: Relative heart rate (%HRmax) and oxygen uptake (%VO2Peak), number of repetitions, and psychological responses (affection: Feeling ScaleFS; Felt Arousal ScaleFAS; enjoyment: Physical Activity Enjoyment ScalePACES) were assessed. FRI and SSRI elicited similar relative average intensity (p > .05) (%HRmax: 88.1 ± 3.5% vs. 87.6 ± 3.0%; %VO2Peak: 55.3 ± 7.4% vs. 54.1 ± 8.1%, respectively). The number of repetitions similarly decreased in SSRI and FRI from rounds 1 to 4 (~15%; p < .006), with no difference of total volume across conditions (FRI: 358.6 ± 32 reps vs. SSRI:357.5 ± 28.2; p = .89). In each round, no difference between FRI and SSRI (p > .05) was found for FS (3- to 3.5 vs. 2- to 4, respectively) or FAS (2- to 4 vs. 2- to 4, respectively), while PACES was lower in FRI than SSRI (102.8 ± 15.8 vs. 109.2 ± 13.2; p = .04). Conclusion: In conclusion, relative intensity, total repetitions, and affective perception were not influenced by the strategy of recovery intervals. On the other hand, overall enjoyment was favored in SSRI vs. FRI.

Risk for post-thrombotic syndrome after lower-limb deep vein thrombosis: location of the thrombus or residual thrombi?

BACKGROUND

Many works aimed to determine factors that influence the onset of postthrombotic syndrome after an acute episode of deep venous thrombosis. We aimed to compare the prognostic value of the most proximal extent of thrombus (proximal and distal DVT) versus the residual thrombosis as identified by venous ultrasonography performed during follow-up.

METHOD

We conducted a retrospective study of prospectively collected 1183 consecutive cohort patients in the RIETE registry after a first episode of deep venous thrombosis and assessed for postthrombotic syndrome after 12 months.

RESULTS

Multivariate analysis revealed that: residual thrombosis (OR 1.40; 95% CI 0,88-2,21), the presence of cancer (OR 1.38; 95% CI: 0,64-2,97), immobility (OR 1.31; 95% CI 0,70-2,43) and estrogen-containing drugs use (OR 2.08, 95% CI 0,63-6,83), all had a predictive value for the occurrence of PTS.

CONCLUSION

Our study results revealed that ultrasound finding of residual thrombosis is more predictive than proximal location of thrombus for postthrombotic syndrome after episode of deep venous thrombosis. Real life data from a large group of patients from the RIETE registry substantiates that.

Newer glucose-lowering drugs at discharge from cardiology hospitalization department: safetyness, effectiveness and mortality reduction

Background

In recent years, the paradigm of glycemic treatment has changed due to the cardiovascular impact of newer glucose-lowering drugs (GLD) (sodium-glucosa cotransporter 2 inhibitor (SGLT2i) and GLP-1 receptor agonist (GLP1a)). The cardiological patient with type 2 diabetes (2DM) is a very high cardiovascular risk patient in which the benefit of these therapies is greater. However, to date, different studies have demonstrated the efficacy and safety of newer GLD only in the outpatient setting. So its impact when they are initiated to discharge after a cardiovascular event is unknown.

Objective

To evaluate the efficacy and safety of the onset of these newer GLD in 2DM patients at discharge from cardiology hospitalization. And to compare mortality and readmissions among patients treated with or without newer GLD.

Methods

Prospective, it includes patients admitted to cardiology at a 3er level hospital between April/2018 and February/2019 with a history of 2DM or diagnosed with 2DM during hospitalization. They were followed at 6, 12 and 18 months. The evolution of anthropometric parameters, glycemic profile, renal function and blood pressure were analyzed; renal events, readmissions, mortality and combined clinical outcome (mortality or readmission) were collected during follow-up. Quantitative variables are expressed in mean/SD and categorical variables in number of patients (%). For the comparison between the parameters at discharge and thefollow-up, a T student was used for paired data. Survival analysis by K-M was performed crude and adjusted data by propensity score matching (PSM).

Results

Population: Diagnoses at discharge: Acute coronary syndrome 66 (64%), Heart failure 22 (21%), Arrhythmias 16 (15%). 104 diabetic patients, 39 of them (38%) were treated on discharge with newer GLD. 35 Patients with SGLT2i without GLP1a, 3 patients with SGLT2i and GLP1a and 1 patient with GLP1a without SGLT2i. The mean follow-up was 16±2 months. Regarding the subgroup of patients with newer GLD: mean age was 65±21 y, male 26 (67%). A significant decrease was observed in glycated hemoglobin (7.6 to 6.9%, p=0.04) and weight (81 to 78 kg, p&lt;0.01) without significant changes in blood pressure or glomerular filtration rate (GFR). Only 1 patient presented deterioration of their GFR that forced the transient suspension of newer GLD.

10 deaths were registered in the classical GLD group (15%) and none in the newer GLD group (HR 0.81 [0.71–0.92] p=0.002, Figure 1A, HR adjusted by PSM 0.9 [0.82–0.99], p=0.04), Figure 1B. The combined clinical outcome appeared in 38 patients (58%) in the the classical GLD group and in 9 (23%) in the newer GLD group (HR 0.70 [0.58–0.85] p&lt;0.001, Figure 1C, PSM adjusted HR 0.75 [0.61–0.92], p=0.001), Figure 1D.

Conclusion

The use of newer GLD at discharge from cardiology hospitalization reduce mortality and readmissions. Newer GLD were safe and showed significant reduction in weigth and glycated hemoglobin.

Figure 1. Kaplan-Meier survival analysis crude and adjusted

Funding Acknowledgement

Type of funding source: None

Etanercept for psoriasis: two case reports

Psoriasis is a chronic inflammatory skin disorder. Recent advances in the understanding of its immunological basis have led to its redefinition as being T-cell mediated. New biological agents have been developed as effective selective target therapies and promise to be an alternative to conventional systemic medications. Etanercept is a recombinant human protein recently approved for psoriatic arthritis treatment that has activity against tumor necrosis factor-alpha (TNF-alpha). It is composed of the human TNF receptor linked to the Fc portion of human IgG1. TNF-alpha seems to play a key role in the pathogenesis of psoriasis and psoriatic arthritis. Therefore, etanercept TNF antagonism is an effective approach for severe psoriasis. We describe two case reports of severe recalcitrant psoriasis, also with arthritis, that showed a remarkable improvement with etanercept, with no adverse events.

Topical tacrolimus in Hailey-Hailey disease

Hailey-Hailey disease, or familial benign chronic pemphigus, is a rare relapsing-remitting autosomal-dominant epidermal blistering disease. It preferentially affects females and is characterized by recurrent vesicles and erosions in the intertriginous areas. There are several topical corticosteroid therapeutic options, which are often limited in their use by their secondary effects and localization of the lesions. We report a case of a 60-year-old woman with Hailey-Hailey disease involving axillary, groin, cervical, antecubital, inframammary and abdominal folds. She was treated with 0.1% tacrolimus ointment, applied twice daily, with clinical improvement in 2 weeks and total remission in 4 weeks. She remains asymptomatic after a 10-month follow-up period.

[Primary acetabular protrusion (author's transl)]

A case of primary protrusion of the acetabulum in a ten year old girl, is presented. A review of the tiology, history, clinical signs and treatment is done. Authors comment the influence of genetic factor in the mother and the father, in the clinical picture of their patient.