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PURPOSE OF REVIEW: Time-restricted eating (TRE), a form of intermittent fasting, restricts feeding time across the day, imposing a daily 'eating window'. The time of day when the eating window occurs could result in differential metabolic effects. Here, we describe recent intervention studies in humans assessing the metabolic consequences of an early- (i.e., eating window starting in the early morning) vs. late (i.e., eating window starting after midday)-TRE protocol. RECENT FINDINGS: Well-controlled studies indicate that both TRE protocols effectively reduce body weight and improve altered glucose metabolism, lipid profile, inflammation, or blood pressure levels. An early-TRE (e-TRE) might have a further positive impact on improving blood glucose, insulin levels, and insulin resistance. However, the studies directly assessing the metabolic consequences of an early- vs. late-TRE have shown dissimilar findings, and more well-controlled clinical trials are needed on the metabolic benefits of these two types of TRE. Evidence suggests that an e-TRE might have enhanced metabolic results, particularly regarding glucose homeostasis. More long-term studies, including larger sample sizes, are needed to assess the metabolic, circadian, and adherence benefits, together with socio-cultural acceptance of both TRE approaches.
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Glicemia , Jejum , Resistência à Insulina , Humanos , Glicemia/metabolismo , Fatores de Tempo , Insulina/sangue , Pressão Sanguínea , Redução de Peso , Peso CorporalRESUMO
Dual antiplatelet therapy is one of the cornerstones of modern percutaneous coronary interventions. The development of new therapeutic agents has significantly reduced ischemic events at the risk of increased bleeding complications. Therefore, efforts are currently focused on optimizing therapeutic algorithms to obtain the greatest anti-thrombotic benefit associated with the lowest risk of bleeding, that is, the greater net clinical benefit. A significant number of trials evaluating different drug combinations or adjustments in treatment duration have been completed. However, clinical translation of these results is often difficult due to the heterogeneity of the therapeutic approaches. The aim of this manuscript is to provide an updated review of the literature regarding the use of dual antiplatelet therapy in patients undergoing coronary angioplasty and stenting.
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Intervenção Coronária Percutânea/métodos , Inibidores da Agregação Plaquetária/uso terapêutico , Humanos , Inibidores da Agregação Plaquetária/farmacologia , Resultado do TratamentoRESUMO
We evaluated the eating pattern, physical activity, and daytime sleepiness level in Chilean shift workers. Fifty, middle-aged adult health workers from a public hospital in Santiago, Chile, were included: a group undergoing shift work (shift workers, including at least one "night shift" and one "long day", n = 33), and day workers under traditional schedule (from 8:00 to 17:00h, n = 17). Body composition, physical activity, and daytime sleepiness levels, and diet characteristics (diet composition, meals' timing, and diet quality) were assessed. Despite similar total energy intake, shift worker showed lower carbohydrate (% of energy) and higher protein intake (both P < 0.01), decreased diet quality, an irregular eating pattern, and delayed meal timing (all P < 0.05). Physical activity and daytime sleepiness levels did not differ between groups. Findings from this first Chilean study in healthcare shift workers support the fact that meal timing and diet quality appear as critical factors for upcoming intervention studies in this group.
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BACKGROUND: Blood flow restriction (BFR) is an effective clinical intervention used to increase strength in healthy individuals. However, its effects on pain and function in individuals with knee pain are unknown. OBJECTIVE: To determine the effectiveness of adding BFR to resistance exercise for pain relief and improvement of function in patients with knee pain. METHODS: Systematic review with meta-analysis of randomized clinical trials. Medline, Central, Embase, PEDro, Lilacs, CINAHL, SPORTDiscus, and Web of Science databases were searched from inception to May 2019. Randomized clinical trials that compared resistance exercise with or without BFR to treat knee pain and function in individuals older than 18 years of age with knee pain were included. RESULTS: Eight randomized clinical trials met the eligibility criteria and for the quantitative synthesis, five studies were included. The pooled standardized mean difference (SMD) estimate showed that resistance exercises with BFR was not more effective than resistance exercises for reducing pain (SMD: -0.37cm, 95% CI=-0.93, 0.19) and improving knee function (SMD=-0.23 points, 95% CI=-0.71, 0.26) in patients with knee pain. CONCLUSION: In the short term, there is low quality of evidence that resistance exercise with BFR does not provide significant differences in pain relief and knee function compared to resistance exercises in patients with knee pain. PROSPERO registration number: CRD42018102839.
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Articulação do Joelho/fisiopatologia , Treinamento Resistido , Terapia por Exercício , Humanos , DorRESUMO
El evento cerebrovascular postoperatorio en cirugía de revascularización miocárdica es una entidad catastrófica que aumenta la morbimortalidad y los costos por atención médica. La literatura muestra una disminución en la incidencia del evento cerebrovascular posterior a cirugía cardiaca en la última década, sin embargo no se dispone de datos sobre la prevalencia de esta entidad en Latinoamérica ni en Colombia. Objetivos: Identificar los factores de riesgo para el desarrollo de evento cerebrovascular temprano, en pacientes sometidos a cirugía de revascularización miocárdica en un centro de referencia colombiano. Métodos: Estudio de casos y controles anidado en una cohorte retrospectiva. Resultados: Se incluyeron 876 pacientes, con edad promedio de 63,6 años ± 9,25 años, de los cuales el 74,5% eran hombres. La incidencia de evento cerebrovascular postoperatorio fue 1,3%. Los factores de riesgo fueron: cirugía valvular ( OR 43,92 { IC 95% 1,26-1527,05} , p = 0,037) ; evento cerebrovascular previo ( OR 14,78 { IC 95% 2,96-73,68} p = 0,01) ; calcificación aórtica ( OR 8,23 { IC 95% 2,18-31,12} , p = 0,02) . Conclusiones: La incidencia de evento cerebrovascular postoperatorio de cirugía de revascularización miocárdica en un centro de referencia colombiano es inferior a la que se reporta en la literatura mundial. Los factores predictivos son la cirugía valvular, el antecedente de evento cerebrovascular y la identificación de calcificación aórtica.
Introduction: Perioperative stroke after coronary artery bypass grafting is a catastrophic complication that increases mobility, mortality and the cost for medical attention. Recently a global decrease in perioperative stroke has been reported, however, there is a lack of data about the prevalence of perioperative stroke in Latin-American and Colombia. Objective: To identify the risk factors for early stroke after coronary artery bypass grafting in a Colombian cardiovascular center. Methods: A retrospective case and control study nested in a cohort was performed. Results: 876 patients were included with a mean age of 63.6 ± 9.25 years, 74.5% were male. The incidence of perioperative stroke was 1.3%. The risk factors identified were: previous valvular surgery OR 43.92 ( 1.26-1527.05) , p:.037, past medical history of stroke OR 14.78 ( 2.96-73.68) , p:.01 and the presence of aortic calcification OR 8.23 ( 2.18-31.12) , p:.02. Conclusions: The incidence of perioperative stroke after coronary artery bypass grafting in a Colombian cardiovascular center is lower than reported in the literature, the perioperative predictors identified in the present study were previous valvular surgery, the past medical history of stroke and aortic calcification.