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Introduction and purpose To examine the effect of cardiorespiratory fitness (CRF) and muscle power output (MPO) on bone mass of prepubertal and pubertal children using lean mass (LM) and percentage of fat mass (%FM) as mediator variables. The hypothesis was that both LM and %FM would be independent mediators of the relationships during the sexual maturation period. Methods We analyzed 200 children (88 boys and 112 girls [11.5 ± 2.0 yr]). Body composition was analyzed by bone densitometry, and indirect calorimetry and cycle ergometer were used to calculate V˙O2peak (mL·kg·min) and MPO (W) during an incremental exercise test. Sample was divided by pubertal status. Results In the prepubertal group, LM and %FM acted independently as mediators in the relationship between bone mass and CRF or MPO (22%-25% for LM and 37%-50% for %FM, respectively). In pubertal children, LM acted as mediator at 37%. Conclusions Although the independent mediator role of LM and %FM in the associations between CRF or MPO and bone mass was present during the prepubertal stage, only LM remain its mediator role in these associations during the postpubertal period. Therefore, with growth and sexual maturation, the full effect of LM seems to increase, whereas the influence of %FM seems to disappear.

We describe the case of an elderly woman with an episode of ambulatory de novo absence status epilepticus of late onset (DNASLO) after oral treatment with cefuroxime. A high level of suspicion of DNASLO in cases of unexplained confusion in adults or elderly subjects taking cephalosporins is essential to prompt an emergency EEG and, in turn, rapidly achieve an appropriate diagnosis and enable optimal treatment.

Generalized tonic status epilepticus (TSE) is a rare epileptic condition. It occurs usually in the context of symptomatic generalized epilepsy, in particular, in subjects with a diagnosis of Lennox-Gastaut syndrome, atypical forms of idiopathic (genetic) generalized epilepsy, or as a paradoxical effect during treatment with diverse antiepileptic drugs. Herein, we describe the case of an elderly woman on chronic treatment with psychotropic drugs who developed an episode of generalized TSE. Motor manifestations were subtle and difficult to recognize as seizures, and a detailed video-EEG importantly contributed to accurate and prompt diagnosis. TSE was initially refractory to conventional anti-seizure drug therapy including levetiracetam and valproate but was finally controlled with lacosamide. Our case indicates a potential therapeutic effect of lacosamide on TSE in the elderly after treatment failure with first-line anti-seizure drugs. [Published with video sequence on www.epilepticdisorders.com].

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.

Aim The aim of this study was to determine the prognosis of 26 consecutive adults with alpha coma (AC), theta coma (TC) or alpha-theta coma (ATC) following CRA and to describe the clinical setting and EEG features of these patients. Methods We retrospective analyzed a prospectively collected cohort of adult patients diagnosed as having AC, TC or ATC after CRA between January 2008 and June 2016. None of patients included in this analysis underwent therapeutic hypothermia (TH). Neurological outcome was expressed as the best score 6 months after CRA using the five-point Glasgow-Pisttsburgh Cerebral Performance Categories (CPC) Results Twenty-six patients were identified with a diagnosis of postanoxic AC, TC or ATC coma. There were 20 (77%) men and 6 (23%) women. The mean age was 63?±?16?years. The most frequent EEG pattern was TC (21 patients, 80%), followed by AC (3 patients, 12%) and ATC (2 patients, 8%). The cardiac rhythm as primary origin of the CRA was ventricular fibrillation (VF) in 16 patients (61.5%), asystole in 8 patients (34.6%) and ventricular tachycardia (VT) in one patient (3.8%). The presence of EEG reactivity was present in 8 patients (30%). The mortality rate was 85%. Of the 4 surviving patients, two (3.8%) had moderate disability (CPC 2), one (3.8%) had severe disability (CPC 3) and one (3.8%) reached a good recovery. The age was significantly lower in survivors 46.2?±?10.8 versus nonsurvivors 63.3?±?15.5 (p?=?0.04). There was increased association of EEG reactivity with survival (p?=?0.07). Conclusion Hypoxic-ischemic AC, TC and ATC are associated with a poor prognosis and a high rate of mortality. In younger patients with AC, TC and ATC and incomplete forms showing reactivity on the EEG, there is a greater probability of clinical recovery.

The main aim of this study was to compare the bone mass of female football players with controls of different pubertal stages.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.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.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.

Objective: The main purpose of the present study is to assess the factor structure and reliability of the Spanish ver sion 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 16.8 years old and with body mass index (BMI) ranging from 13.2 to 41.1 kg/m2 ). None of them had either a his tory 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: Uncon trolled 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 rel ative 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 be tween eating behaviors and other health-related behaviors such as physical activity time or cardiovascular fitness.

Background and aims: Exercise training can improve health of patients with metabolic syndrome(MetS).However,whichMetS factors aremost 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 eightMetS patients (52 8.8 yrs old; 33 4 BMI) underwent 4months (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 exercisemaximal fat oxidation (FOMAx) also progressively improved with training ( 17 5; 21 2 and 31 8%, respectively, after 4months; all P < 0.05). Vastus lateralis samples fromseven 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 1e2 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 arewaist circumference, blood pressure and the muscle and systemic adaptations to consume oxygen and fat. However, the latter reverse with detraining while blood pressure andwaist circumference are persistent to one month of detraining.

While current exercise guidelines recommend progressive, high-intensity resistance training (RT) to promote muscle hypertrophy and strength gains, controversy exists regarding the efficacy of lighter-load RT. We compared 2 work-matched RT interventions that differed in training intensity.Fifteen women underwent 10 weeks of unilateral knee extensor RT. One leg was trained at increasing intensity (intensity leg, InL, 50-80% 1-repetition maximum [1-RM]), and training progression in the contralateral leg (volume leg, VoL, 50% 1-RM) was based on increasing training volumes. Quadriceps muscle size (ultrasound, dual energy X-ray absorptiometry) and strength (isokinetic dynamometry) were assessed on 4 occasions.Both training programs induced significant, yet comparable increases in muscle size (InL: +4.6-12%, VoL: +3.1-11%) and strength (InL: +10-16%, VoL: +10-14%).Training at lower than commonly suggested intensities may be an equally effective alternative form of RT. Factors other than training intensity, such as the total mechanical work during training, may strongly affect the training response.