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array:23 [ "pii" => "S2387020615000273" "issn" => "23870206" "doi" => "10.1016/j.medcle.2013.10.001" "estado" => "S300" "fechaPublicacion" => "2015-01-20" "aid" => "2791" "copyright" => "Elsevier España, S.L.U.. All rights reserved" "copyrightAnyo" => "2013" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Med Clin. 2015;144:59-61" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 158 "formatos" => array:2 [ "HTML" => 90 "PDF" => 68 ] ] "itemSiguiente" => array:19 [ "pii" => "S2387020615000418" "issn" => "23870206" "doi" => "10.1016/j.medcle.2014.03.003" "estado" => "S300" "fechaPublicacion" => "2015-01-20" "aid" => "2939" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Med Clin. 2015;144:62-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 144 "formatos" => array:2 [ "HTML" => 103 "PDF" => 41 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial article</span>" "titulo" => "Chronotherapy with anti-hypertensive drugs to improve blood pressure control and reduce the vascular risk" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "62" "paginaFinal" => "64" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Cronoterapia con antihipertensivos para mejorar el control de la presión arterial y reducir el riesgo vascular" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ramón C. Hermida" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Ramón C." "apellidos" => "Hermida" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775314002280" "doi" => "10.1016/j.medcli.2014.03.010" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775314002280?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020615000418?idApp=UINPBA00004N" "url" => "/23870206/0000014400000002/v1_201509250127/S2387020615000418/v1_201509250127/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2387020615000352" "issn" => "23870206" "doi" => "10.1016/j.medcle.2014.02.005" "estado" => "S300" "fechaPublicacion" => "2015-01-20" "aid" => "2924" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Med Clin. 2015;144:55-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 152 "formatos" => array:2 [ "HTML" => 81 "PDF" => 71 ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Non-alcoholic fatty liver in children and adolescents with excess weight and obesity" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "55" "paginaFinal" => "58" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hígado graso no alcohólico en pacientes con sobrepeso y obesidad infantojuvenil" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Guadalupe Guijarro de Armas, Susana Monereo Megías, Cristina Navea Aguilera, María Merino Viveros, M. Belén Vega Piñero" "autores" => array:5 [ 0 => array:2 [ "nombre" => "M. Guadalupe" "apellidos" => "Guijarro de Armas" ] 1 => array:2 [ "nombre" => "Susana" "apellidos" => "Monereo Megías" ] 2 => array:2 [ "nombre" => "Cristina" "apellidos" => "Navea Aguilera" ] 3 => array:2 [ "nombre" => "María Merino" "apellidos" => "Viveros" ] 4 => array:2 [ "nombre" => "M. Belén" "apellidos" => "Vega Piñero" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S002577531400195X" "doi" => "10.1016/j.medcli.2014.02.018" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S002577531400195X?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020615000352?idApp=UINPBA00004N" "url" => "/23870206/0000014400000002/v1_201509250127/S2387020615000352/v1_201509250127/en/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Brief report</span>" "titulo" => "Reduction of exercise-mediated endothelial dysfunction markers in sedentary adults with chronic spinal cord injury" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "59" "paginaFinal" => "61" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Manuel Rosety-Rodriguez, Alejandra Camacho-Molina, Ignacio Rosety, Gabriel Fornieles, Miguel A. Rosety, Francisco Javier Ordoñez" "autores" => array:6 [ 0 => array:3 [ "nombre" => "Manuel" "apellidos" => "Rosety-Rodriguez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "Alejandra" "apellidos" => "Camacho-Molina" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Ignacio" "apellidos" => "Rosety" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "Gabriel" "apellidos" => "Fornieles" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "Miguel A." "apellidos" => "Rosety" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 5 => array:4 [ "nombre" => "Francisco Javier" "apellidos" => "Ordoñez" "email" => array:1 [ 0 => "franciscojavier.ordonez@uca.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Departamento de Medicina, Universidad de Cádiz, Cádiz, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital Juan Ramón Jiménez, Huelva, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Escuela de Medicina del Deporte, Universidad de Cádiz, Cádiz, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Reducción de marcadores de disfunción endotelial mediante ejercicio en adultos sedentarios con lesión medular crónica" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The increase in the life expectancy in patients with chronic spinal cord injury (cSCI) has been associated with an increased cardiovascular morbidity and mortality.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> Apart from a sedentary lifestyle, several cardiovascular risk factors are more common in patients with spinal cord injury: metabolic alterations (insulin resistance, dyslipidaemias) and changes in body composition (loss of muscular mass, increase in abdominal fat), among others.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> Furthermore, patients with cSCI have higher values of systemic chronic inflammation and endothelial dysfunction markers.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Exercise improves many of these atherogenic factors, including the proinflammatory state.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> However, the effects of exercise on endothelial dysfunction shown by patients with cSCI have not been previously studied. We have conducted a prospective study to assess the effects of a supervised training programme on the values of markers of endothelial activation in adult male patients with cSCI.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Patients and method</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Patients</span><p id="par0015" class="elsevierStylePara elsevierViewall">Seventeen adult male patients with sedentary lifestyles with cSCI equivalent to or below T5 volunteered for the study. We agreed on this level because the functionality of patients with injury equivalent to or above T4 is limited by lower cardiac expenditure.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> The control group included eight out of the 17 participants whose baseline characteristics are summarised in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Inclusion criteria included the following: male sex, age between 25 and 35 years, traumatic injury equivalent to or below T5, spinal cord post-injury during 4–5 years, satisfactory medical examination prior to participation. Exclusion criteria included the following: failure to complete, at least, 90% of scheduled work sessions, having participated in a training programme within the last 6 months and having a disease which prevented the patient from participating in the exercise programme.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Method</span><p id="par0025" class="elsevierStylePara elsevierViewall">Participants were randomly assigned to an intervention group (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>9) with a 12-week crank ergometer exercise programme with three sessions/week. Each session included warm-up (5–10<span class="elsevierStyleHsp" style=""></span>min) and main activities that lasted 20–30<span class="elsevierStyleHsp" style=""></span>min (which were increased by 2<span class="elsevierStyleHsp" style=""></span>min and 30<span class="elsevierStyleHsp" style=""></span>s every 3 weeks), with a moderate intensity of 50–65% of the maximum reserve heart rate (RHR) (which began at 50% and was increased by 5% every 3 weeks). To conduct a before–after analysis, upon completion of the open randomised study, these eight participants were included in the structured exercise programme. Baseline characteristics of participants are summarised in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The RHR was determined by means of the equation:<elsevierMultimedia ident="eq0005"></elsevierMultimedia></p><p id="par0035" class="elsevierStylePara elsevierViewall">The peak heart rate (HR) was obtained through the pre-test maximum effort test. Resting HR was determined through the medical recognition prior to participation. Work sessions were supervised using cardio frequency monitors (Polar PE 3000). Participants took part in familiarisation sessions on the use of ergometers.</p><p id="par0040" class="elsevierStylePara elsevierViewall">All participants (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>17) carried out maximal incremental effort tests using crank ergometers at the beginning and at the end of the study to determine their aerobic capacity (VO<span class="elsevierStyleInf">2</span>max).</p><p id="par0045" class="elsevierStylePara elsevierViewall">Antecubital vein blood samples were collected from all participants after 10–12<span class="elsevierStyleHsp" style=""></span>h overnight fasting, when they were included in the study and after effort tests. After centrifugation during 10<span class="elsevierStyleHsp" style=""></span>min at 3000<span class="elsevierStyleHsp" style=""></span>rpm, plasma samples were collected and stored in a freezer at −70<span class="elsevierStyleHsp" style=""></span>°C until study variables were determined. Endothelin-1, <span class="elsevierStyleItalic">soluble intercellular adhesion molecule-1</span> (slCAM-1) and <span class="elsevierStyleItalic">soluble vascular cell adhesion molecule-1</span> (sVCAM-1) values were determined by enzyme immunoanalysis using kits sold by R&D Systems (Minneapolis, USA). Finally, the total fat mass percentage was determined by electric bioimpedanciometry at a frequency of 50<span class="elsevierStyleHsp" style=""></span>Hz.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Prior to beginning, there was an informative session for participants, who signed the pertinent consent form. Our study follows the recommendations of the Declaration of Helsinki (2007) and has been approved by an Institutional Ethics Committee.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Statistical analysis</span><p id="par0055" class="elsevierStylePara elsevierViewall">Results are expressed as a mean (SD). The normal nature of the distribution was demonstrated by the Shapiro–Wilk test due to the limited sample size. Mean values were compared using the one-way ANOVA test with <span class="elsevierStyleItalic">post hoc</span> correction of the Bonferroni test for multiple determinations. The significance level was set at <span class="elsevierStyleItalic">α</span> of 0.05. Finally, the effect size was determined by Cohen's <span class="elsevierStyleItalic">d</span>-test: effect was weak if 0.2<span class="elsevierStyleHsp" style=""></span>≤<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">d</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.5, moderate if 0.5<span class="elsevierStyleHsp" style=""></span>≤<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">d</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.8 and strong for values of <span class="elsevierStyleItalic">d</span><span class="elsevierStyleHsp" style=""></span>≥<span class="elsevierStyleHsp" style=""></span>8.</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Results</span><p id="par0060" class="elsevierStylePara elsevierViewall">Upon completion of the 12-week intervention programme, there was an aerobic capacity improvement in participants expressed as a significant increase in VO<span class="elsevierStyleInf">2</span>max in the comparative study (mean [SD] of 23.2 [2.1] compared to 25.6 [1.9]<span class="elsevierStyleHsp" style=""></span>ml/kg/min, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.037), which was more significant in the before–after study (mean of 22.9 [1.8] compared to 26.0 [2.0]<span class="elsevierStyleHsp" style=""></span>ml/kg/min, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.01). At the same time, there was a significant reduction in the total fat mass percentage in both the comparative study (mean of 27.1 [5.3] compared to 26.0 [5.4]%, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.041) and the before–after study (mean of 27.3 [5.5] compared to 26.1 [5.3]%, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.02).</p><p id="par0065" class="elsevierStylePara elsevierViewall">Plasma values of endothelin-1 and sICAM-1 were significantly reduced in both the comparative study and the before–after study (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">There were no significant changes in any of the tested variables in the control group. There were no injuries or retirements during the study.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Discussion</span><p id="par0075" class="elsevierStylePara elsevierViewall">This study shows that a physical exercise programme during 12 weeks reduces endothelial inflammation markers (plasma values of endothelin-1 and sICAM-1) in patients with cSCI. These results expand the known benefits of physical exercise for the improvement of the endothelial function in patients with cSCI described in a recent systematic revision.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> Similar results have recently been published for patients with essential high blood pressure<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> and patients with intermittent claudication, especially among patients who used a crank ergometer, such as the one used in our study.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">However, physical exercise has not modified the increase in endothelial inflammation markers in other patients. A before–after study conducted in non-diabetic obese patients and obese patients with diabetes mellitus type 2 who completed a training programme (during 12<span class="elsevierStyleHsp" style=""></span>weeks, four sessions/week at 70% of VO<span class="elsevierStyleInf">2</span>max) showed no changes in baseline values of endothelial inflammation markers.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> Also, there were no changes in the body mass index, waist/hip ratio, systolic or diastolic blood pressure, glycohemoglobin or aerobic capacity (VO<span class="elsevierStyleInf">2</span>max) upon completion of the programme,<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> which demonstrates that the training programme was not intense or lengthy enough to improve the value of vascular inflammation markers in obese or diabetic subjects.</p><p id="par0085" class="elsevierStylePara elsevierViewall">Reduction in endothelial inflammation markers may be due to the significant reduction in the body fat mass percentage after exercise, as it occurred in obese adult patients<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> with exercise and a hypocaloric diet.</p><p id="par0090" class="elsevierStylePara elsevierViewall">The absence of injuries or retirements shows that the training programme is safe and easy to follow, especially when it is addressed to patients with disability.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> Having achieved the planned objectives in our study would not be as important as participants including exercise in their lifestyles, since endothelin-1 values recover pre-intervention values a few weeks after having completed the training programme.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">The main limitations of the study are its short-term design and small sample size. To override these weaknesses, we conducted a double prospective study (randomised comparative study and before–after study) using a homogeneous sample of adult male patients with low cSCI, unlike studies that include tetraplegic and paraplegic patients. In the comparative study, the control group included patients with cSCI with sex and age adjustments, unlike previous studies that included the general population with no spine cord damage.</p><p id="par0100" class="elsevierStylePara elsevierViewall">In conclusion, a 12-week, supervised crank ergometer exercise programme reduces the values of endothelial dysfunction markers in adult male patients with cSCI. To understand the impact of endothelial activation improvement regarding the clinical evolution of these patients, studies with a larger sample size and clinical follow-up are necessary.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflict of interest</span><p id="par0105" class="elsevierStylePara elsevierViewall">The authors declare that there are no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres558808" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background and objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Method" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec574557" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres558807" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Fundamento y objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Método" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec574558" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Patients and method" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Patients" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Method" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Statistical analysis" ] ] ] 6 => array:2 [ "identificador" => "sec0030" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0035" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0040" "titulo" => "Conflict of interest" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2013-05-04" "fechaAceptado" => "2013-10-17" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec574557" "palabras" => array:4 [ 0 => "Chronic spinal cord injury" 1 => "Endothelial activation" 2 => "Endothelial function" 3 => "Exercise" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec574558" "palabras" => array:4 [ 0 => "Lesión medular crónica" 1 => "Activación endotelial" 2 => "Función endotelial" 3 => "Ejercicio" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background and objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Recent studies have found increased markers of endothelial activation in men with chronic spinal cord injury. This study was conducted to determine the effects of arm-cranking exercise on endothelial dysfunction in male adults with chronic SCI.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Method</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A prospective randomised study of 17 sedentary adult males with chronic SCI at or under T5 level. Nine performed a supervised exercise programme at a moderate intensity (arm-cranking: 12 weeks, 3 sessions/week). Plasma levels of endothelin-1, soluble intercellular adhesion molecule type 1 (sICAM-1), and soluble vascular adhesion molecule type 1 (sVCAM-1) were assessed by ELISA. Outcome measurements also included physical fitness and total body fat mass percentage.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">We observed both in the randomised and in the before–after studies a significant reduction of the levels of endothelin-1 and sICAM-1. Furthermore, significant improvements of both physical fitness and body composition were also found.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Arm-cranking exercise improved endothelial dysfunction in adult males with chronic SCI. Long-term studies are still required to determine whether the correction of endothelial dysfunction improves the clinical outcomes of adults with chronic SCI.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background and objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Method" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Fundamento y objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La morbimortalidad cardiovascular se ha incrementado entre las personas con lesión medular crónica (LMC). Se planteó como objetivo determinar el efecto del ejercicio sobre marcadores de disfunción endotelial en adultos sedentarios con LMC.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Método</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio prospectivo aleatorizado en 17 adultos varones con LMC a nivel o debajo de T5. Nueve de ellos realizaron un programa supervisado de ejercicios en ergómetro de manivela a intensidad moderada (12 semanas, 3 sesiones/semana). Se determinaron mediante enzimoinmunoanálisis los valores plasmáticos de endotelina-1, fracción soluble de la molécula de adhesión celular vascular tipo-1, y fracción soluble de la molécula de adhesión intercelular tipo-1 (sICAM-1), antes y después del programa de ejercicio. La capacidad aeróbica y el porcentaje de masa grasa también fueron evaluados.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Tras completar el programa de entrenamiento, tanto en el estudio comparativo como en el estudio antes-después, se observó una disminución significativa de los valores de endotelina-1 y fracción soluble de la molécula de adhesión intercelular tipo-1. Asimismo, se observó una mejora estadísticamente significativa de la capacidad aeróbica y la composición corporal.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusión</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">El ejercicio mejoró la disfunción endotelial en varones adultos con LMC.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Fundamento y objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Método" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Please cite this article as: Rosety-Rodriguez M, Camacho-Molina A, Rosety I, Fornieles G, Rosety MA, Ordoñez FJ. Reducción de marcadores de disfunción endotelial mediante ejercicio en adultos sedentarios con lesión medular crónica. Med Clin (Barc). 2015;144:59–61.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">AI, anthropometric index obtained using the equation proposed by Bulbulian et al. (Med Sci Sports Exerc. 1987; 19:195–201); <span class="elsevierStyleItalic">Fitness</span>, expressed as maximum oxygen consumption; BMI, body mass index.</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Values expressed as a mean (SD).</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>17) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Intervention (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>9) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Control (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>8) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Age (years) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">29.8 (3.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">29.6 (3.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">30.2 (3.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Duration of injury (months) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">55.3 (3.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">54.8 (3.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">55.7 (3.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">BMI (kg/m<span class="elsevierStyleSup">2</span>) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27.7 (4.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27.6 (4.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27.8 (4.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">AI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28.4 (4.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28.3 (5.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28.5 (4.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Fitness</span> (ml/kg/min) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23.1 (2.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23.2 (2.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23.0 (2.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab901780.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Baseline characteristics of all participants, as well as those assigned to intervention and control groups.</p>" ] ] 1 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">sICAM-1, soluble intercellular adhesion molecule-1; sVCAM-1, soluble vascular cell adhesion molecule-1.</p><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Values expressed as a mean (SD).</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="2" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Intervention group</th><th class="td" title="table-head " colspan="2" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Control group</th><th class="td" title="table-head " align="left" valign="top" scope="col">Cohen's <span class="elsevierStyleItalic">d</span> test \t\t\t\t\t\t\n \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pre-test \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Post-test \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Before \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">After \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Endothelin-1 (pg/ml) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.44 (0.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.23 (0.3)<a class="elsevierStyleCrossRefs" href="#tblfn0005"><span class="elsevierStyleSup">*,**</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.40 (0.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.41 (0.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.60 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">sICAM-1 (ng/ml) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">313 (81) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">279 (77)<a class="elsevierStyleCrossRefs" href="#tblfn0005"><span class="elsevierStyleSup">*,**</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">319.0 (80) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">321 (80) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.52 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">sVCAM-1 (ng/ml) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1240 (233) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1210 (226) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1255 (228) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1253 (229) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.19 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab901781.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "*" "nota" => "<p class="elsevierStyleNotepara" id="npar0005"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05 compared to pre-test.</p>" ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "**" "nota" => "<p class="elsevierStyleNotepara" id="npar0010"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05 compared to control group (after).</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Endothelial function markers in adult patients with chronic spinal cord injury: impact of a 12-week, supervised training programme.</p>" ] ] 2 => array:5 [ "identificador" => "eq0005" "tipo" => "MULTIMEDIAFORMULA" "mostrarFloat" => false "mostrarDisplay" => true "Formula" => array:5 [ "Matematica" => "FCR=(FC actividad−FC reposo)×(FC pico−FC reposo−1)×100%." "Fichero" => "STRIPIN_si1.jpeg" "Tamanyo" => 4100 "Alto" => 18 "Ancho" => 458 ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Management of cardiovascular disease risk factors in individuals with chronic spinal cord injury: an evidence-based review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.J. Cragg" 1 => "J.A. Stone" 2 => "A.V. 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Rosa" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1155/2013/971841" "Revista" => array:5 [ "tituloSerie" => "Mediators Inflamm" "fecha" => "2013" "volumen" => "2013" "paginaInicial" => "971841" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23533315" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0070" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Exercise recommendations for individuals with spinal cord injury" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P.L. Jacobs" 1 => "M.S. Nash" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Sports Med" "fecha" => "2004" "volumen" => "34" "paginaInicial" => "727" "paginaFinal" => "751" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15456347" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0075" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A systematic review of exercise as a therapeutic intervention to improve arterial function in persons living with spinal cord injury" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A.A. Phillips" 1 => "A.T. Cote" 2 => "D.E. 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