Limited Physical Activity Research Articles

Probiotics as an Adjunct Approach to the Prevention and Treatment of Colon Cancer: A Review

Abstract:: One out of every six people in the world is suffering from cancer disease. The major causes of cancer are high consumption of tobacco, high body mass index, and alcoholic beverages with low intake of a healthy diet and limited physical activity. Colon cancer is one of the leading causes of cancer-related morbidity worldwide. In the past few years, probiotics have drawn a lot of interest as potential preventive and therapeutic anticancer agents. This literature review addressed both human and animal research that has explored the association between probiotics and colon cancer. Probiotic administration has remarkable potential for the prevention and treatment of colon cancer through various mechanisms such as inhibiting the growth of cancer cells via apoptosis, improving immune activity, restoring gut microbiota, improving intestinal barrier properties, synthesizing anticarcinogenic compounds, and degrading carcinogenic compounds. Therefore, probiotics emerge as an adjunct therapy, holding the potential to significantly reduce the risk of colorectal cancer.

O2 consumption overshoot in patients with heart failure: crossing the line

Abstract Background Cardiopulmonary exercise testing (CPET) is among the most valuable clinical tools for evaluating disease severity and physical activity limitations in heart failure (HF) patients. Peak oxygen uptake (pVO2) reflects maximal cardiac output during exercise, and it is considered a major parameter in selecting candidates for cardiac transplantation. VO2 overshoot, a transient increase in VO2 during recovery from maximal exercise, has been frequently observed in HF patients and is attributed to the transient increase in cardiac output caused by the mismatch between cardiac contractility and afterload reduction. However, the prognostic significance of this phenomenon remains to be fully established. Purpose This study aimed to characterize the prognostic significance of VO2 overshoot following peak exercise in individuals with HF. Methods This retrospective single-center study included consecutive adult patients with chronic (>3 months) and stable HF, with left ventricular ejection fraction (LVEF) <50%, who underwent CPET between 2015 and 2020. Following maximal exercise, patients recovered over a 3-minute period (walking 2km/h for 1 minute and sitting passively for 2 minutes). VO2 overshoot kinetics during recovery were measured and described as the time until post-exercise VO2 fell below pVO2 for at least 15 seconds. Please refer to Figure 1A for an example of normal and prolonged VO2 overshoot. The study endpoint was time to cardiovascular (CV) death, urgent cardiac transplant, or left ventricular assist device (LVAD) over 1-year follow-up. Results A total of 254 patients were included (mean age 59 ± 12 years; 83% males; mean LVEF 34 ± 9%; 70% with ischemic HF; 77% in NYHA class II-III; mean pVO2 18 ± 6 mL/kg/min; mean predicted pVO2% 52 ± 16%; mean VE/VCO2 slope 41 ± 13). The VO2 overshoot had a normal distribution (Figure 1B) and lasted on average for 45 ± 33 seconds. There were no differences between patients that had an overshoot higher and below average. Overall, during follow-up, 25 patients met the composite endpoint (12 CV deaths, 9 urgent heart transplants, and 4 LVAD). Univariate analysis showed a significant relationship between VO2 overshoot and the outcome of interest (HR 1.01, 95% CI 1.00 – 1.02, p=0.027). In multivariate analysis, this association remained significant, even after adjusting for pVO2 and VE/VCO2 slope (HR 1.01, CI 95% 1.00– 1.02, p=0.026). Conclusion This study delves into the intriguing phenomenon of VO2 overshoot in patients with heart failure, shedding light on its potential prognostic significance. The independent association between VO2 overshoot and the composite endpoint suggests that this transient increase in oxygen consumption may carry prognostic value. Further studies should confirm these findings.

Identification of spontaneous patient-reported complaints related to perianal fistula in patients with Crohn's disease.

To identify patient-reported complaints affecting quality of life in Crohn's disease patients with a perianal fistula, and to compare differences between subgroups. A questionnaire was distributed to 1667 patients from the Dutch Crohn's and Colitis Patients' organization, those patients with Crohn's disease and perianal fistula were included. Patients were asked to report (using free text) their most important fistula-related complaints affecting their quality of life. All responses were structurally analyzed and categorized. Data comparisons were made between subgroups: women versus men, patients with versus without current presence of a seton, and patients aged ≤40 versus >40 years. Of 743 respondents (44.6%), 123 patients with Crohn's disease and perianal fistula were included (92 women, median age 41 years [IQR 34-56] and 36 with seton). A total of 776 complaints were allocated to 36 categories, with 19 reported in >10% of patients. Perianal fistula-related complaints affected nearly all patients (95.9%). Impact on psychological status (71.7% vs. 29.0%; p < 0.0001) and on sexual activities (37.0% vs. 16.1%; p = 0.003) were more common in women than men. Younger patients more often reported insecurity (38.7% vs. 18.0%; p = 0.026), shame (29.0% vs. 11.5%; p = 0.024), and impact on sexual activities (40.3% vs. 23.0%; p = 0.048) than older patients. Patients with a seton more frequently reported self-experienced malodour (50.0% vs. 23.0%; p = 0.005), physical activity limitations (41.7% vs. 19.5%; p = 0.014), and work/study impact (22.2% vs. 5.7%; p = 0.019). We identified 19 perianal fistula-related complaints reported by >10% of patients. These complaints may guide improvement of current outcome measures.

The Level and Limitations of Physical Activity in Elderly Patients with Diabetes

Background/Objectives: Old age and illnesses can limit physical activity (PA). We have assessed the level of PA and its limitations in older people with diabetes (DM). Methods: Cross-sectional study, period: January and June 2024, place: Diabetes Center, subjects: patients (N = 207) &gt; 64 years with DM), Surveying using: IPAQ, Accompanying Survey (AS). The significance was assessed by: Student’s t-test, Mann–Whitney U test, Pearson’s test. The relationships between the IPAQ and the AS results were analyzed based on a meta-analysis model for variable effects, OR with a 95% CI. ROC curve was used to determine the threshold values for age, BMI. Correlations between selected key variables were evaluated using the PCA. Results: The median age: 72 years (65–87), BMI: 28.70 (18.61–49.69). The median PA level: 1837 MET-min/week (0–9.891). The individuals who obtained insufficient (n = 28), sufficient (n = 75), and high levels of PA (n = 53) were 17.95%, 48.08%, and 33.97%, respectively. Diseases were the main factor limiting PA (53.54%) in patient’s opinion, followed by the lack of a companion or motivation. The meta-analysis found no diseases linked to insufficient PA, but those with BMI &gt; 33.3 and over 75 years old more often had insufficient PA. PCA revealed several characteristics that predispose individuals to insufficient PA. Conclusions: People over 75 years of age tend to avoid PA more than younger seniors, leading to its insufficient level, similarly like higher BMI. The individual with DM who has an insufficient level of PA is typically a single, woman, over 75, BMI &gt; 33.

Анализ взаимосвязи между частотой возникновения падений пациентов и уровнем культуры безопасности в медицинской организации

The problem of patient falls in healthcare organizations is a pressing concern for modern healthcare. Falls can lead to serious consequences, including significant limitations in physical activity, the development of anxiety disorders, and depression. Additionally, fall-related injuries are associated with high costs for treatment and rehabilitation. Special comprehensive programs are implemented in healthcare organizations to prevent falls, but the success of their implementation largely depends on the level of safety culture among healthcare personnel. The aim of this study is to investigate the relationship between the level of safety culture among healthcare personnel and the frequency of patient falls. Methods. The study was conducted in the multidisciplinary clinic JSC «Medicina» in Moscow from 2014 to 2020. The safety culture was assessed using the SOPS Hospital Survey 1.0 (HSPSC). The frequency of falls was evaluated based on online forms filled out by staff. Results. The study assessed the dynamics of the fall frequency per 1,000 bed-days in the hospital. Falls were categorized according to the severity of associated injuries. A correlation was found between the fall frequency and safety culture composites, such as «teamwork» –0.826 (p=0.022), «learning from errors» –0.747 (p=0.049), «executive actions in support of patient safety» –0.760 (p=0.047), «overall impression on patient safety» –0.821 (p=0.024), «frequency of reported incidents» 0.782 (p=0.038), «openness of communication» –0.846 (p=0.017), «unit collaboration» –0.867 (p=0.012), «shift handoffs and patient transfers» –0.791 (p=0.034), «non-punitive response to errors» 0.838 (p=0.019), and «average level of safety culture across all composites» –0.809 (p=0.027) (table 1). Conclusion. The study confirms the importance of assessing safety culture as part of a comprehensive approach to prevent patient falls in hospitals. The level of safety culture among healthcare personnel is inversely correlated with the frequency of patient falls. An increase in the level of safety culture is associated with a decrease in fall frequency and a reduction in the number of associated injuries. Additionally, the level of safety culture may potentially serve as an integral indicator of the effectiveness of programs aimed at preventing adverse events related to medical care. The study’s findings are relevant for a wide range of readers interested in issues related to healthcare safety.

Review of femoroacetabular impingement syndrome

Abstract Femoroacetabular impingement syndrome (FAIS) is a common condition of the hip that can cause significant damage to the joint, leading to degeneration and osteoarthritis. FAIS constitutes an abnormal and dynamic contact between the femoral head–neck junction and the acetabular rim, resulting from altered bone morphology at one or both sites. Repetitive trauma at the site of impingement generates progressive damage to the acetabular labrum, chondrolabral junction, and articular cartilage. Proper diagnosis based on patient symptoms, specific clinical signs, and imaging findings will guide treatment and ultimately allow preservation of the native hip joint. Common symptoms in patients with FAIS include pain, clicking, catching, buckling, stiffness, giving way, and a limited range of motion of the hip. Specific clinical maneuvers can aid diagnosis, such as flexion adduction internal rotation and flexion abduction external rotation tests. Imaging diagnosis includes orthogonal hip and pelvis X-ray views, as well as magnetic resonance imaging/magnetic resonance arthrogram imaging. Initial treatment of FAIS can be conservative and include physical therapy, intra-articular injections, and activity modification. Currently, the preferred surgical management consists of hip arthroscopy, which aims to correct bony abnormalities, repair or reconstruct labral lesions and address other intra-articular and extra-articular derangements as needed.

Progress in health-related quality of life in patients with pulmonary hypertension

Pulmonary hypertension is a disease that impairs cardiopulmonary function and is characterised by the limitation of progressive physical activity and decline in health-related quality of life. Patients usually present with a range of severe symptoms, including dyspnoea, fatigue, chest pain and oedema, which affect their quality of life. Compared to the general population, patients usually have a lower health-related quality of life, with differences in several aspects such as physical functioning, mental health, social interactions and career. The aim of this review is to examine recent research advances in health-related quality of life in patients with pulmonary hypertension, including its influencing factors and improvement measures, in order to improve the understanding and management of this condition.

Fact or Fiction-Accelerometry Versus Self-Report in Adherence to Pediatric Concussion Protocols: Prospective Longitudinal Cohort Study.

Concussion, or mild traumatic brain injury, is a growing public health concern, affecting approximately 1.2% of the population annually. Among children aged 1-17 years, concussion had the highest weighted prevalence compared to other injury types, highlighting the importance of addressing this issue among the youth population. This study aimed to assess adherence to Return to Activity (RTA) protocols among youth with concussion and to determine if better adherence affected time to recovery and the rate of reinjury. Children and youth (N=139) aged 5-18 years with concussion were recruited. Self-reported symptoms and protocol stage of recovery were monitored every 48 hours until symptom resolution was achieved. Daily accelerometry was assessed with the ActiGraph. Data were collected to evaluate adherence to the RTA protocol based on physical activity cutoff points corresponding to RTA stages. Participants were evaluated using a battery of physical, cognitive, and behavioral measures at recruitment, upon symptom resolution, and 3 months post symptom resolution. For RTA stage 1, a total of 13% of participants were adherent based on accelerometry, whereas 11% and 34% of participants were adherent for stage 2 and 3, respectively. The median time to symptom resolution was 13 days for participants who were subjectively reported adherent to the RTA protocol and 20 days for those who were subjectively reported as nonadherent (P=.03). No significant agreement was found between self-report of adherence and objective actigraphy adherence to the RTA protocol as well as to other clinical outcomes, such as depression, quality of life, and balance. The rate of reinjury among the entire cohort was 2% (n=3). Overall, adherence to staged protocols post concussion was minimal when assessed with accelerometers, but adherence was higher by self-report. More physical activity restrictions, as specified in the RTA protocol, resulted in lower adherence. Although objective adherence was low, reinjury rate was lower than expected, suggesting a protective effect of being monitored and increased youth awareness of protocols. The results of this study support the move to less restrictive protocols and earlier resumption of daily activities that have since been implemented in more recent protocols.

12546 Association Of Quality Of Life And Age At Diagnosis In Women With Turner Syndrome

Abstract Disclosure: G. Julian: None. L.J. Folsom: None. Background: There is a well-documented association between chronic disease and decreased quality of life (QoL), including in women with Turner syndrome (TS). Much of the existing research exploring QoL in women with Turner syndrome primarily establishes the finding of decreased QoL; fewer studies seek to explore potential etiologies for this finding. Health-related QoL (HRQoL) has been evaluated using the HRQOL 14, a validated measure of QoL, since 1995, and in individuals &amp;gt;12 years of age as part of National Health and Nutrition Examination Survey (NHANES). The primary objective of our study was to investigate the relationship between HRQoL in women with TS and age of TS diagnosis (AoD). A secondary aim included identification of correlations between medical treatment history and HRQoL. Methods: After obtaining IRB approval, the electronic medical record (EMR) was queried using the “slicer-dicer” feature using search and limiting criteria based on desired and specified variables. Inclusion criteria encompassed a documented diagnosis of TS, a recorded office visit within the past 2 years, and participant age of at least 18 years at time of study initiation. Exclusion criteria included lack of a confirmed diagnosis of TS, presence of other diseases known to influence stature or pubertal development, inability to understand the survey, lack of ability to read or speak English, and diagnosis of TS within the past year. QoL was assessed using the HRQOL 14. After review for exclusion criteria an opt-out letter was mailed via USPS. Results: Thirty participants completed the study out of 84 qualifying individuals. Early AoD was defined as younger than 13 years; late AoD was defined as &amp;gt;12 years. Twenty-four participants met criteria for early AoD; six met criteria for late AoD. The mean age for early diagnosis was 6 years and the mean age for late diagnosis was 23 years. The early AoD group reported fewer medical problems (3.6 vs. 6.2 other medical problems, p=0.009), was less likely to state days of lack of sufficient sleep (4.5 vs. 30 days, p=0.001), and was less likely to note days of limited physical activity due to pain (1 vs. 15 days, p=0.007). Conclusions: The novel finding of association of earlier AoD of TS and fewer medical problems invites the possibility that other health conditions may be more effectively managed if TS is diagnosed earlier. This finding highlights the opportunity for enhanced care with earlier AoD. Presentation: 6/1/2024

Choice of Alternative Method of Surgical Intervention in Abdominal Rectus Diastasis with Concomitant Midline Hernias

INTRODUCTION: To date, no consensus has been achieved on the most appropriate surgical method for the treatment of abdominal rectus diastasis concomitant with midline hernias. AIM: Study of the results of three original methods of surgical treatment of patients with abdominal rectus diastasis concomitant with midline hernias. MATERIALS AND METHODS: The results of treatment of 74 patients have been analyzed. The patients were divided into three comparable groups: in the first group (n = 25), repair with local tissues with formation of aponeurotic duplication was performed, in the second group (n = 24), autodermal de-epithelialized graft was used, in the third group (n = 25) — mesh sub-lay implants. The following parameters were evaluated: duration of narcotic analgesia in the postoperative period, period of activation of patients, periods of inpatient treatment and results on Clavien-Dindo and EuraHSQoL scales. The follow-up period was from 1 to 10 years after surgery. RESULTS: The period of postoperative use of narcotic analgesics was 1.08 ± 0.38 days in the first group, 0.98 ± 0.33 days in the second group, 2.13 ± 0.93 days in the third group. The period of activation was 3.00 ± 1.53 days in the first group, 0.89 ± 0.36 days in the second group, 1.5 ± 0.48 days in the third group; the duration of inpatient treatment was 9.24 ± 1.88 bed-days, 6.34 ± 3.04 bed-days and 8.36 ± 2.14 bed-days, respectively. Postoperative complications in the first group were CDI class 6, CDII class 3, in the second group CDI class 1, in the third group CDI class 6, CDII class 3. At 12 months after the operation, painful sensations and functional discomfort on EuraHSQoL scale were absent in the second group, in the first and third groups, limitations in physical activity were noted (р ≤ 0.05; differences between the first and third groups were statistically insignificant, p ≥ 0.05). There were no statistically significant differences in the cosmetic discomfort between the groups (p ≥ 0.05). CONCLUSION: A safer and more effective method of repair of the anterior abdominal wall in patients with concomitant abdominal rectus diastasis and midline hernias is plastic surgery with application of de-epithelialized autodermal graft.

High-flow nasal cannula in adults with chronic respiratory diseases during physical exercise: a systematic review and meta-analysis

BackgroundChronic respiratory diseases (CRDs) affect at least 545 million people globally, leading to symptoms such as dyspnoea, fatigue and limited physical activity. Pulmonary rehabilitation (PR) programmes aim to improve the...

Patient Experience With Efanesoctocog Alfa for Severe Hemophilia A: Results From the XTEND-1 Phase 3 Clinical Study Exit Interviews

PurposeHemophilia A is a rare bleeding disorder that leads to recurrent hemarthrosis, which can ultimately result in reduced mobility and poor quality of life. Qualitative exit interviews provide insights into patient perspectives and support the interpretation of quantitative trial data, such as patient-reported outcome measures. In the Phase 3 XTEND-1 study (NCT04161495) of efanesoctocog alfa in participants with severe hemophilia A, exit interviews were conducted to understand pre- and post-study experiences with pain and physical functioning and to evaluate participants’ treatment experiences. MethodsIn XTEND-1, participants (≥12 years old) received once-weekly efanesoctocog alfa prophylaxis 50 IU/kg for 52 weeks (Arm A) or on-demand efanesoctocog alfa 50 IU/kg for 26 weeks followed by 26 weeks once-weekly prophylaxis (50 IU/kg; Arm B). Optional qualitative exit interviews were conducted using a semi-structured guide in a subset of participants following study completion. Interviews included open-ended questions about participants’ pre- and post-study experiences with hemophilia A and targeted questions relating to improvements in patient-reported outcomes assessed during XTEND-1, including the Haemophilia Quality of Life Questionnaire for Adults Physical Health subscale (Haem-A-QoL PH). Content validity of the Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Intensity 3a measure was also assessed, particularly the worst pain item. FindingsExit interviews were conducted with 29 of 159 patients enrolled in XTEND-1 (mean [range] age 40 [16−73] years). Of 17 participants enrolled in Arm A, 13 (76.5%) reported a “wearing off” feeling with pre-study treatment, including more aches/pain, breakthrough bleeds, and limited physical activities. Joint pain was the most reported pre-study symptom (96.6%; n = 28/29), followed by a reduced ability to move without pain (89.7%, n = 26/29). Improvements following efanesoctocog alfa prophylaxis in ≥1 Haem-A-QoL PH domain were reported by 89.7% (n = 26/29) of participants, with improvements in joint pain, the ability to move without pain, and painful swellings reported by at least 21 (84%) participants. Participants reported that the PROMIS Pain Intensity 3a items were relevant, clear, and easy to answer. Most participants (96.6%) were “quite satisfied” or “very satisfied” with efanesoctocog alfa prophylaxis. All participants preferred efanesoctocog alfa over pre-study treatment. ImplicationsThe exit interviews demonstrated that once-weekly efanesoctocog alfa prophylaxis resulted in patient-relevant and meaningful improvements in pain and physical functioning, consistent with the quantitative findings from XTEND-1. These results support the validity of the Haem-A-QoL PH and PROMIS Pain Intensity 3a assessed during XTEND-1, demonstrating the potential for change with efficacious treatment. Trial RegistryClinicalTrials.gov Trial Registration NumberNCT04161495 Registry URLhttps://clinicaltrials.gov/study/NCT04161495

Cluster-analysis of human pulse wave by self-organizing Cohonen maps to identify markers of age groups

The present study is methodological in nature and describes an approach to the study of the human cardiovascular system. The assessment of biological age is important for the management of the human aging process. Regular monitoring of this indicator makes it possible to take preventive measures to reduce the likelihood of cardiovascular disasters. The aim of the study is to determine the age groups based on the pulse waves of the subjects using Kohonen neural networks. In this study, Kohonen self-organizing maps were used to cluster pulse waves of people of different ages by observing the dy-namic change of the pulse wave with the selection of parameters of the neural network self-organization algorithm. A data set of different age groups was used. Each group con-tained files of subjects of the same age, each file – pulse waves of these subjects. As a result of experiments with neural network configurations, cluster structures were obtained and geometric characteristics of pulse waves corresponding to age groups were estab-lished. The clustering algorithm used broke the pulse waves into clusters, the reliability of which in some cases reached 91–96 %. The software implementation of the trained neural network and the portability of the pulse wave measuring device allow the proposed tech-nique to be used to monitor the state of the cardiovascular system in people at risk of cardiovascular disasters, as well as people associated with dangerous professions, ath-letes, office workers, etc. Registration of changes in biological age contributes to the adoption of timely preventive measures, decisions on the modification of nutrition, life-style and physical activity. The resulting network can be used in diagnostic systems to support medical decision-making.

Unfair Racial Treatment in Healthcare, Healthcare Utilization, and Health Status Among Black, Indigenous, Women of Color

Black, Indigenous, Women of Color (BIWOC) face well-documented health disparities in the United States. However, the extent to which recent experiences of unfair racial treatment in medical settings contribute to health disparities is not well understood. The objective of this study was to examine associations of experiencing unfair racial treatment by a provider during the most recent medical encounter with healthcare utilization and health status in BIWOC. We utilized multivariate logistic regression models to examine data from the Association of American Medical Colleges’ biannual Survey of Healthcare Access collected between 2012 and 2019. Data were extracted for 5,549 participants who identified both as a woman and a Black, Indigenous, Person of Color to generate our BIWOC sample of interest. Among BIWOC, experiencing unfair racial treatment during their most recent healthcare visit in the past year was associated with higher odds of delaying healthcare ( OR = 3.50, p &lt; .001) and using the emergency department as their usual source of care ( OR = 1.54, p &lt; .001). Experiencing unfair racial treatment was also associated with having chronic physical conditions ( OR = 1.31, p = .002), chronic depression ( OR = 1.56, p &lt; .001), and activity limitations due to both emotional ( OR = 2.98, p &lt; .001) and physical ( OR = 2.47, p &lt; .001) impairment. Recent experience of racial discrimination by a healthcare provider was associated with lower healthcare utilization and poorer health status in a national sample of BIWOC. Reducing unfair treatment in healthcare settings is critical for improving BIWOC health.

Keep on truckin’: how effective are health behaviour interventions on truck drivers’ health? A systematic review and meta-analysis

BackgroundTruck drivers are a vital workforce, but have higher rates of obesity and other chronic diseases than the general population. The occupation’s sedentary nature, limited physical activity opportunities and access to healthy food, and irregular sleeping patterns contribute to poor health. This systematic review and meta-analysis aimed to evaluate the effectiveness of interventions on health behaviours and cardiometabolic biomarkers of health in truck drivers.MethodsA systematic search was conducted in February 2024, and reported according to PRISMA 2020 guidelines. Experimental studies targeting physical activity, sedentary behaviour, sleep, diet, weight loss, drug/alcohol use, and/or smoking were eligible. Two reviewers independently screened and completed data extraction and risk of bias assessment. Data were combined at the study level. Pooled statistics were calculated using mean differences (MD) or standardised mean differences (SMD) for outcomes that were reported in ≥2 studies. Pre- and post-intervention means and standard deviations (SD) for the intervention and control groups were used to compute effect sizes.ResultsNineteen studies (n=2137 participants) were included. Meta-analyses found a small-to-moderate increase in fruit and vegetable consumption (SMD 0.32, p=0.03) with no other significant effects on other outcome variables.ConclusionsInterventions are moderately effective in increasing truck drivers’ fruit and vegetable consumption, but not other outcomes. There is a dearth of research in the driver population compared to other occupational groups. Future interventions should consider workplace and environmental factors to promote the health and wellbeing of truck drivers.Trial registrationThe study protocol was registered on PROSPERO (CRD42021283423).

Impact of lifestyle on erectile dysfunction: literature review and educational recommendations

Introduction: Erectile dysfunction (ED) represents a significant health problem that can have a negative impact on men's quality of life, intimate relationships and self-esteem. ED is a marker of overall health, requiring a comprehensive diagnostic and therapeutic approach. This article highlights the need for an integrated approach, in which lifestyle modifications are key to the successful treatment of erectile dysfunction. Aim of the study: The aim of this article is to provide a comprehensive review of the literature on erectile dysfunction, with the intention of improving understanding of the condition and providing directions for future research and clinical practice. Materials and methods: Electronic databases, including PubMed, Scopus, Web of Science, and Google Scholar, were searched to identify studies and literature reviews on erectile dysfunction (ED). The state of knowledge: This review examines the epidemiology, pathophysiology, and risk factors associated with ED, emphasizing the importance of lifestyle in prevention and treatment. The role of diet, physical activity, weight reduction, smoking cessation, and alcohol restriction in improving erectile function is discussed. The article also presents current diagnostic and therapeutic approaches, including pharmacotherapy, alternative therapies and psychological interventions. Conclusions: Erectile dysfunction (ED) is a complex health issue that necessitates a comprehensive and interdisciplinary diagnostic and therapeutic approach. Lifestyle plays a pivotal role in the prevention and treatment of ED, and its modification should be an integral component of any treatment plan.

Beyond the Playground: Challenges in Physical Education (PE) for Students with Additional Needs. A case Study Exploration

This study aimed to explore the multifaceted challenges encountered among students with additional needs in physical education (PE) classes. This study explored the various experiences of six students with additional needs who were subjected to semi-structured interviews in the physical education class participation at the MSU-Iligan Institute of Technology. The findings revealed two sub-themes: barriers to physical activity, which can be categorized as physical activity limitations and disability-related academic barriers, and psychosocial barriers, which include self-worth struggle and social exclusion in physical education (PE) classes. These barriers highlight the need for inclusive and adaptable physical education programs that cater the diverse needs of all students and create an atmosphere where everyone may actively engage and derive benefits from participating in physical education. Future studies should prioritize exploring educational interventions that effectively break down these challenges to enhance attitudes toward disabilities and promote social inclusion for students with additional needs.

Beyond weight loss: the potential of glucagon-like peptide-1 receptor agonists for treating heart failure with preserved ejection fraction.

Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous syndrome with various phenotypes, and obesity is one of the most common and clinically relevant phenotypes of HFpEF. Obesity contributes to HFpEF through multiple mechanisms, including sodium retention, neurohormonal dysregulation, altered energy substrate metabolism, expansion of visceral adipose tissue, and low-grade systemic inflammation. Glucagon-like peptide-1 (GLP-1) is a hormone in the incretin family. It is produced by specialized cells called neuroendocrine L cells located in the distal ileum and colon. GLP-1 reduces blood glucose levels by promoting glucose-dependent insulin secretion from pancreatic β cells, suppressing glucagon release from pancreatic α cells, and blocking hepatic gluconeogenesis. Recent evidence suggests that GLP-1 receptor agonists (GLP-1 RAs) can significantly improve physical activity limitations and exercise capacity in obese patients with HFpEF. The possible cardioprotective mechanisms of GLP-1 RAs include reducing epicardial fat tissue thickness, preventing activation of the renin-angiotensin-aldosterone system, improving myocardial energy metabolism, reducing systemic inflammation and cardiac oxidative stress, and delaying the progression of atherosclerosis. This review examines the impact of obesity on the underlying mechanisms of HFpEF, summarizes the trial data on cardiovascular outcomes of GLP-1 RAs in patients with type 2 diabetes mellitus, and highlights the potential cardioprotective mechanisms of GLP-1 RAs to give a pathophysiological and clinical rationale for using GLP-1 RAs in obese HFpEF patients.

Association of Weight Status and Waist Circumference with Physical Activity in people with Schizophrenia Spectrum Disorders and healthy controls

BackgroundIndividuals with Schizophrenia Spectrum Disorders (SSD) often suffer from obesity and do limited Physical Activity (PA). PA has many beneficial effects on a variety of somatic and mental variables and it should be strengthened among people with mental disorders. The relationship between Body Mass Index (BMI), Waist Circumference (WC), and PA in this population is poorly understood, with a lack of precise PA assessment. This study investigates the association between BMI, WC, weight, and PA in individuals with SSD and controls using accelerometers. MethodsOne hundred twenty-six patients with SSD (residents and outpatients) and 110 sex- and age-matched controls were enrolled. Clinical, sociodemographic, and quality-of-life data were collected. PA was measured with a tri-axial ActiGraph GT9X and quantified by Vector Magnitude (VM). Relationships between PA and BMI, WC, and weight changes were analysed using linear regression models. ResultsPatients were more likely to be unmarried, unemployed, and less educated compared to controls (p < 0.001). Residents had more medical comorbidities (p = 0.001), while outpatients had higher BMI, weight, and WC (p < 0.001). Residents reported more severe psychopathology, lower functioning, and greater use of psychopharmacological medications (p < 0.001). Higher PA levels were not significantly associated with lower BMI, WC, or weight. Although not statistically significant, increased PA showed a trend towards lower obesity risk. ConclusionsSociodemographic, medical, and clinical characteristics of individuals with SSD define vulnerability factors that can inform tailored interventions to improve PA.

Daily and Weekly Associations Among Pain Intensity, Self-Reported Activity Limitations, and Objectively Assessed Physical Activity in Youth With Acute Musculoskeletal Pain

Monitoring recovery during acute pain episodes is useful for identifying youth at risk for pain persisting. Subjective and objective measures can assess function postinjury, but associations among these different measures and pain patterns in the acute period are unknown. To fill this gap, we examined associations among self-reported activity limitations, objectively measured physical activity, and pain intensity in 176 youth (age 11–17, 46% male) seeking health care for acute musculoskeletal pain. Participants completed 7-day electronic diaries rating daily pain intensity and activity limitations (Child Activity Limitations Interview [CALI]) while concurrently wearing an Actiwatch to record physical activity. The results revealed youth reported pain on 47.8% of days with an average intensity of 33.4 (0–100). Averaged across the week, between-participant analyses showed greater activity limitations were associated with lower mean (rActive = −.204, rRoutine = −.159, P < .05) and peak activity (rActive = −.291, rRoutine = −.184, P < .05). Same-day correlations between CALI scores and physical activity measures within participants were not significant. Linear mixed-effects models revealed higher daily pain intensity was associated with greater self-reported activity limitations on Routine (β = .23, P < .001) and Active CALI-9 subscales (β = .07, P < .001). Conversely, higher daily pain was associated with higher activity on actigraphy, specifically higher mean activity (β = .46, P < .01), more activity bouts (β = .013, P < .01), more time in light activity (β = .04, P < .01), and less sedentary time (β = −.04, P < .01). Taken together, self-reported activity limitations and objective physical activity represent 2 distinct, yet related, aspects of physical functioning associated with pain. Future work should examine how physical activity and activity limitations change longitudinally and predict pain persistence. PerspectiveThis study examined daily associations between pain intensity, self-reported activity limitations, and objectively assessed physical activity in youth during the acute recovery period following a musculoskeletal injury. Self-reported activity limitations and objective physical activity represent 2 distinct, yet related, aspects of physical functioning that are associated with pain.