Background Physical inactivity is one of the leading modifiable risk factors for non-communicable disease burden globally. Commercial gyms represent accessible settings for structured physical activity; however, little is known about the health profile of their attendees or whether individuals with the greatest clinical need for exercise effectively engage in supervised, adequate physical activity. This study aimed to characterize gym attendees by sociodemographic profile, health status, and self-reported functional capacity and to assess whether those with the highest clinical need for structured exercise are those who most effectively engage in it. Methods Observational, descriptive, cross-sectional study conducted via a self-administered digital questionnaire among adults aged ≥ 16 years attending commercial or community gyms in Greater Buenos Aires, Argentina (April 2026). Sociodemographic variables, chronic disease history, type and frequency of physical activity, technical supervision, primary motivation for training, and self-reported functional capacity (simplified Health Assessment Questionnaire Disability Index, HAQ-DI) were collected. Participants were classified into high clinical need (presence of ≥ 1 medical comorbidity and/or age ≥ 65 years) and low clinical need groups. Descriptive statistics and between-group comparisons (chi-square, Mann-Whitney U) were performed using Jamovi v2.x and Python (pandas/scipy). Results A total of 205 participants were analyzed (mean age 43.0 ± 14.9 years; 72.4% female). Sixty-eight percent reported no chronic disease; 23.5% reported chronic musculoskeletal pain. High clinical need was identified in 74 participants (36.1%). Compared to the low-need group, high-need participants trained less frequently (occasional training: 18.8% vs. 4.6%); they p = 0.002), more frequently chose low-impact modalities such as yoga/Pilates/flexibility (26.1% vs. 8.4%). p = 0.005), more often trained without any technical supervision (18.6% vs. 8.4%; p = 0.014), and more rarely cited medical prescription as their primary motivation (8.6% vs. 1.5%; p = 0.042). Supervision by a physiotherapist or health specialist was virtually absent in both groups (≤ 4.3%). The mean global HAQ-DI score was 0.049 ± 0.105; grip was the most affected functional domain (12.6% with any difficulty). Conclusions Despite accessing the same gym facilities as the general population, individuals with the highest clinical need for structured physical activity trained less frequently, at lower intensity, and with minimal specialized supervision. Gym attendance does not guarantee an exercise dose or quality adequate to clinical needs. There is an urgent need for systematic exercise prescription by healthcare professionals and for stronger linkages between health services and community exercise facilities, particularly for individuals with chronic comorbidities.
Background:Early-onset colorectal cancer (EOCRC) is increasing worldwide and now accounts for a growing share of cancer deaths in younger adults. Data from middle- and low-income regions are scarce. We aimed to characterize the incidence, tumor stage distribution, lymph node positivity and metastasis patterns of EOCRC in Argentina. Methods:In this retrospective, multicenter cohort study, we analyzed adult patients who underwent colorectal cancer surgery between April 2022 and December 2023. The registry included 1829 patients, of whom 961 were male (52.5%) and 868 were female (47.5%). Mean age was 41.6 years (range 18-49) in the EOCRC group and 68.8 years (range 50-98) in the late-onset colorectal cancer (LOCRC) group. Descriptive statistics were used to summarize patient and tumor characteristics. Comparisons between EOCRC (<50 years) and LOCRC (≥50 years) were performed using χ2 tests. Ethnicity data were not available. Findings:EOCRC accounted for 15.4% of surgically treated cases, with over two-thirds occurring among individuals aged 40-49 years. Compared with LOCRC, EOCRC patients more frequently presented with advanced tumor stages (T3-T4), higher lymph node positivity, and a greater prevalence of metastases. Tumor location differed between groups, with EOCRC predominating in the rectum and LOCRC showing a right-sided predominance. Interpretation:This national multicenter surgical registry analysis reveals substantial differences in stage and metastatic burden between younger and older colorectal cancer patients in Argentina. The high prevalence of advanced disease among individuals aged 40-49 years supports consideration of earlier initiation of colorectal cancer screening. Funding:The Universidad Abierta Interamericana provided partial funding for the publication of this work.
Invasive intracranial pressure (ICP) monitoring is considered the gold standard for the management of patients with an acute brain injury and at risk of developing intracranial hypertension (IH). However, invasive devices (e.g., intraparenchymal probe or external ventricular drain) are expensive, not available worldwide, and might be associated with some risks. Recently, a consensus for the monitoring and management of traumatic brain injury (TBI) patients when invasive ICP is not available (B-ICONIC) was developed. This approach is based on repeated neurological evaluation, neuroimaging, and the use of non-invasive ICP monitoring tools, such as transcranial Doppler, automated pupillometry, and ultrasound optic nerve sheath diameter measurement, to titrate interventions aiming at controlling ICP. Despite this clinical algorithm was mainly proposed for low and middle-income countries where invasive ICP is not widely implemented, a potential application of this approach may exist even in healthcare facilities where direct ICP monitoring is available. This includes patients who may have contraindications to invasive monitoring, such as coagulopathy, as well as those in whom ICP monitoring is not routinely implemented, such as individuals with post-anoxic brain injury or acute liver failure, for the reported occurrence of cerebral edema and potential risk of IH in these cases. Therefore, the aim of this manuscript is to propose the extension of the B-ICONIC algorithm to a wider population, regardless of the decision to insert an ICP sensor, and to guide their management using this multimodal approach.
