Zinc transporters expression profile in professional handball players supplemented with zinc.

INTRODUCTION: Zinc (Zn) deficiency has been described not only on general human health but also within the sports context -as negatively affecting performance-. Thus, Zn status assessment is of great interest for athletes, especially in order to correct deficiency states of this mineral. OBJECTIVE: The overall objective of this work was to assess Zn status in professional handball players during the competitive period (through plasma levels, dietary intake and gene expression of the Zn transporters), as well as to determine the effect of Zn supplementation. METHODS: A total of twenty-two participants were recruited, -twelve belonged to the Control Group (CG) and ten male handball players comprised the experimental group (ATH-G)-, being monitored over a 2-month period with 2 evaluation moments: baseline (i.e., initial conditions) and follow-up (i.e., after 8 weeks of training and competition). Zn intake, plasma Zn levels, and gene expression of Zn transporters were obtained. RESULTS: Plasma Zn levels were higher in ATH-G than in CG at the end of Zn intervention (p ≤ 0.010). Moreover, differences in the gene expression profile of Zn transporters were observed in ATH-G -with the down-regulation of several Zn transporters-, compared to the CG at baseline (p ≤ 0.05). Likewise, differences in the Zn transporters expression were observed in ATH-G at 8 weeks (all, p ≤ 0.001) -with ZnT2, ZnT5, ZIP3, ZIP5, ZIP11, ZIP13 and ZIP14 transporters being up-regulated-. CONCLUSION: Handball players seemed to have different nutritional needs for Zn, with differences in the gene expression of Zn transporters compared to controls. Zn intervention in our athletes may have influenced the expression of Zn transporters, indicating a potential increase in Zn transporters expression to mobilize Zn at the cellular level at 8 weeks of Zn intervention.

Biomarkers of macular neovascularisation activity using optical coherence tomography angiography in treated stable neovascular age related macular degeneration.

BACKGROUND: The aim of this study was to describe features of disease activity in patients with treated stable macular neovascularisation (MNV) in neovascular age related macular degeneration (nAMD) using optical coherence tomography angiography (OCTA). METHODS: Thirty-two eyes of 32 patients with nAMD were included in this prospective, observational study. These patients were undergoing treatment with aflibercept on a treat-and-extend regimen attending an extension to a 12-week treatment interval. RESULTS: All subjects had no macular haemorrhage and no structural OCT markers of active MNV activity at the index 12-week treatment extension visit. 31/32 OCTA images were gradeable without significant imaging artefact. The mean MNV size was 3.6mm2 ± 4.6mm2 and 27 (87.1%) had detectable MNV blood flow. 29/31 (93.5%) subjects had MNV with mature phenotypes including 10 non-specific, 10 tangle and 3 deadtree phenotypes. MNV halo and MNV central feeder vessel were noted in 18 (58.1%) and 19 (61.3%) of subjects respectively; only 1 (3.2%) subject was noted to have a MNV capillary fringe. CONCLUSIONS: MNV blood flow is still detectable using OCTA in the majority of subjects in this study with treated stable MNV. OCTA features associated included MNV mature phenotype, MNV feeder vessel, MNV halo and absence of capillary fringe.

Network analytics for drug repurposing in COVID-19.

To better understand the potential of drug repurposing in COVID-19, we analyzed control strategies over essential host factors for SARS-CoV-2 infection. We constructed comprehensive directed protein-protein interaction (PPI) networks integrating the top-ranked host factors, the drug target proteins and directed PPI data. We analyzed the networks to identify drug targets and combinations thereof that offer efficient control over the host factors. We validated our findings against clinical studies data and bioinformatics studies. Our method offers a new insight into the molecular details of the disease and into potentially new therapy targets for it. Our approach for drug repurposing is significant beyond COVID-19 and may be applied also to other diseases.

Validation and Clinical Applicability of Whole-Volume Automated Segmentation of Optical Coherence Tomography in Retinal Disease Using Deep Learning.

IMPORTANCE: Quantitative volumetric measures of retinal disease in optical coherence tomography (OCT) scans are infeasible to perform owing to the time required for manual grading. Expert-level deep learning systems for automatic OCT segmentation have recently been developed. However, the potential clinical applicability of these systems is largely unknown. OBJECTIVE: To evaluate a deep learning model for whole-volume segmentation of 4 clinically important pathological features and assess clinical applicability. DESIGN, SETTING, PARTICIPANTS: This diagnostic study used OCT data from 173 patients with a total of 15 558 B-scans, treated at Moorfields Eye Hospital. The data set included 2 common OCT devices and 2 macular conditions: wet age-related macular degeneration (107 scans) and diabetic macular edema (66 scans), covering the full range of severity, and from 3 points during treatment. Two expert graders performed pixel-level segmentations of intraretinal fluid, subretinal fluid, subretinal hyperreflective material, and pigment epithelial detachment, including all B-scans in each OCT volume, taking as long as 50 hours per scan. Quantitative evaluation of whole-volume model segmentations was performed. Qualitative evaluation of clinical applicability by 3 retinal experts was also conducted. Data were collected from June 1, 2012, to January 31, 2017, for set 1 and from January 1 to December 31, 2017, for set 2; graded between November 2018 and January 2020; and analyzed from February 2020 to November 2020. MAIN OUTCOMES AND MEASURES: Rating and stack ranking for clinical applicability by retinal specialists, model-grader agreement for voxelwise segmentations, and total volume evaluated using Dice similarity coefficients, Bland-Altman plots, and intraclass correlation coefficients. RESULTS: Among the 173 patients included in the analysis (92 [53%] women), qualitative assessment found that automated whole-volume segmentation ranked better than or comparable to at least 1 expert grader in 127 scans (73%; 95% CI, 66%-79%). A neutral or positive rating was given to 135 model segmentations (78%; 95% CI, 71%-84%) and 309 expert gradings (2 per scan) (89%; 95% CI, 86%-92%). The model was rated neutrally or positively in 86% to 92% of diabetic macular edema scans and 53% to 87% of age-related macular degeneration scans. Intraclass correlations ranged from 0.33 (95% CI, 0.08-0.96) to 0.96 (95% CI, 0.90-0.99). Dice similarity coefficients ranged from 0.43 (95% CI, 0.29-0.66) to 0.78 (95% CI, 0.57-0.85). CONCLUSIONS AND RELEVANCE: This deep learning-based segmentation tool provided clinically useful measures of retinal disease that would otherwise be infeasible to obtain. Qualitative evaluation was additionally important to reveal clinical applicability for both care management and research.

IDENTIFICATION OF INCREASED BLUE LIGHT REFLECTIVITY IN MACULAR TELANGIECTASIA TYPE 2 USING SCANNING LASER OPHTHALMOSCOPY VERSUS RED-FREE FUNDUS PHOTOGRAPHY.

PURPOSE: To compare two modalities used for detection of the characteristic parafoveal hyperreflective area seen in macular telangiectasia Type 2. METHODS: Scanning laser ophthalmoscope blue light reflectance was compared with red-free fundus photography imaging. Images were obtained as part of the international Natural History Study of Macular Telangiectasia (MacTel Study). RESULTS: The hyperreflective area can more frequently be seen with scanning laser ophthalmoscope blue light reflectance than with red-free imaging. CONCLUSION: Detection of the hyperreflective area might help to identify macular telangiectasia in earlier disease stages. Scanning laser ophthalmoscope blue light reflectance should be preferred as a diagnostic tool when the suspicion of macular telangiectasia arises. However, red-free imaging offers a viable option to scanning laser ophthalmoscope blue light reflectance when good quality is achieved.

Changes in zinc status and zinc transporters expression in whole blood of patients with Systemic Inflammatory Response Syndrome (SIRS).

INTRODUCTION: Critically ill patients develop severe stress, inflammation and a clinical state that may raise the utilization and metabolic replacement of many nutrients and especially zinc, depleting their body reserves. This study was designed to assess the zinc status in critical care patients with systemic inflammatory response syndrome (SIRS), comparing them with a group of healthy people, and studying the association with expression of zinc transporters. MATERIAL AND METHODS: This investigation was a prospective, multicentre, comparative, observational and analytic study. Twelve critically ill patients from different hospitals and 12 healthy subjects from Granada, Spain, all with informed consent were recruited. Data on daily nutritional assessment, ICU severity scores, inflammation, clinical and nutritional parameters, plasma and blood cell zinc concentrations, and levels of transcripts for zinc transporters in whole blood were taken at admission and at the seventh day of the ICU stay. RESULTS: Zinc levels on critical ill patient are diminish comparing with the healthy control (HS: 0.94 ±â€¯0.19; CIPF: 0.67 ±â€¯0.16 mg/dL). The 58% of critical ill patients showed zinc plasma deficiency at beginning of study while 50.0% of critical ill after 7 days of ICU stay. ZnT7, ZIP4 and ZIP9 were the zinc transporters with highest expression in whole blood. In general, all zinc transporters were significantly down-regulated (P < 0.05) in the critical ill population at admission in comparison with healthy subjects. Severity scores and inflammation were significantly associated (P < 0.05) with zinc plasma levels, and zinc transporters ZIP3, ZIP4, ZIP8, ZnT6, ZnT7. Expression of 11 out of 24 zinc transporters was analysed, and ZnT1, ZnT4, ZnT5 and ZIP4, which were downregulated by more than 3-fold in whole blood of patients. CONCLUSION: In summary, in our study an alteration of zinc status was related with the severity-of-illness scores and inflammation in critical ill patients since admission in ICU stay. SIRS caused a general shut-down of expression of zinc transporters in whole blood. That behavior was associated with severity and inflammation of patients at ICU admission regardless zinc status. We conclude that zinc transporters in blood might be useful indicators of severity of systemic inflammation and outcome for critically ill patients.

LONGITUDINAL CORRELATION OF ELLIPSOID ZONE LOSS AND FUNCTIONAL LOSS IN MACULAR TELANGIECTASIA TYPE 2.

PURPOSE: To compare ellipsoid zone (EZ) loss and functional loss in macular telangiectasia (MacTel) type 2 longitudinally. METHODS: Prospective natural history study. Ellipsoid zone loss was measured in en-face images created from spectral domain optical coherence tomography. Functional loss was assessed by best-corrected visual acuity and microperimetry, counting the number of test points with impaired function. RESULTS: A total of 56 eyes of 31 participants were followed for 4.5 ± 1.2 years. Ellipsoid zone loss was 18,600 ± 3,917.3 pixel at baseline (≈0.59 mm) and increased 2,627.8 ± 427.9 pixel (≈0.08 mm) per year. Best-corrected visual acuity decreased 2.2 ± 0.9 letters per year. Change in EZ loss correlated significantly with change in relative and absolute scotomas (r = 0.62; P-value < 0.0001 and r = 0.72; P-value < 0.0001), but not with loss of best-corrected visual acuity. Functional loss showed a similar frequency of progression as EZ loss, but a higher rate of "regression," likely due to higher variability of the measurement, assuming a progressive neurodegenerative disease. CONCLUSION: The results of the authors support EZ loss as surrogate measure for visual function in MacTel type 2. Being objective, EZ loss might be considered more suitable than microperimetry as primary end point in future interventional trials.

SCOTOMA CHARACTERISTICS IN MACULAR TELANGIECTASIA TYPE 2: MacTel Project Report No. 7-The MacTel Research Group.

PURPOSE: To characterize scotomas in macular telangiectasia Type 2 (MacTel). METHODS: Five of the 27 centers performed microperimetry as part of the MacTel Natural History Observation Study. Data were analyzed in the Moorfields Eye Hospital Reading Centre. The number of stimuli under a threshold of 12, 10, 8, and <0 dB were counted (thresholding) and compared with one another. RESULTS: A total of 565 examinations were gradable, received from 632 eyes of 322 participants (age 61.1 ± 9.1 years, 62% females). The authors found absolute scotomas in 243 eyes (43%), 98% of these affected the temporal quadrant, and 99.5% were unifocal. Growth of absolute scotomas was limited to an extent of approximately 40 deg. Although transition from functionally unimpaired retina to absolute scotomas is generally steeply sloped, the larger a scotoma, the steeper it is. CONCLUSION: Scotoma features were consistent throughout a large MacTel cohort. The temporal quadrant was confirmed as predominantly affected, which might result from vascular or metabolic asymmetry. Functional loss did not exceed an area of 5° × 8° however advanced the disorder. Different MacTel phenotypes seem likely and point toward different types of progression; identifying these would improve planning for clinical trials and might lead to better understanding patient outcome.

Pyridoxal-5'-phosphate deficiency is associated with hyperhomocysteinemia regardless of antioxidant, thiamine, riboflavin, cobalamine, and folate status in critically ill patients.

BACKGROUND & AIMS: Critically ill patients develop severe stress, inflammation and a clinical state that may raise the utilization and metabolic replacement of pyridoxal-5'-phosphate decreasing their body reserves. This study was designed to assess the nutritional pyridoxal-5'-phosphate status in critical care patients with systemic inflammatory response syndrome, comparing them with a group of healthy people, and studying it's association with factors involved in the pyridoxine and other B vitamins metabolism, as the total antioxidant capacity and Hcy as cardiovascular risk biomarker. METHODS: Prospective, multicentre, comparative, observational and analytic study. One hundred and three critically ill patients from different hospitals, and eighty four healthy subjects from Granada, Spain, all with informed consent. Data from daily nutritional assessment, ICU severity scores, clinical and nutritional parameters, antioxidant status and homocysteine levels was taken at admission and at the seventh day of the ICU stay. RESULTS: Thiamine, riboflavin, pyridoxine and folate status proved deficient in a large number of patients, being significantly lower in comparison with control group, and significantly decreased at 7th day of ICU stay. Higher homocysteine was observed in patients compared with control group (p < 0.05) where 31.5 and 26.8 percent of subjects presented hyperhomocysteinemia at initial and final of study, respectively. Antioxidant status was lower than control group in two periods analysed, and decreased at 7th day of ICU stay (p < 0.05) being associated with PLP deficiency. PLP deficiency was also correlated with hyperhomocysteinemia at two times measured (r. -0.73, p < 0.001; r. -0.69, p < 0.001, respectively), showing at day 7 an odds ratio of 6.62 in our multivariate model. CONCLUSION: Critically ill patients with SIRS show deficient B vitamin and low antioxidant statuses. Despite association found between PLP deficiency and low antioxidant status in critically ill patients, PLP deficiency was only associated with hyperhomocysteinemia regardless of antioxidant, riboflavin, cobalamine, and folate statuses in critically ill patients with SIRS at seventh day of ICU stay. PLP deficient patients presented about six times more risk of cardiovascular disease than non deficients.

IMBALANCES IN PROTEIN METABOLISM IN CRITICAL CARE PATIENT WITH SYSTEMIC INFLAMMATORY RESPONSE SYNDROME AT ADMISSION IN INTENSIVE CARE UNIT.

BACKGROUND: trauma and severe infections cause remarkable metabolic changes in patient with SIRS from an adaptive response aimed to control the underlying disease, repairing damaged tissue, and to synthesize substrates. If the attack is intense and sustained and the patient has a compromised nutritional status, can evolve into multiple organ failure and death. OBJECTIVE: assessment of nutritional proteic status and the involvement of proteins and inflammatory factors in critically ill patients. METHOD: multicenter observational analytical study in critical ill patients at the admission in ICU. RESULTS AND DISCUSSION: patients showed disturbances in clinical nutritional parameters which confirm their hypercatabolic situation, showing malnutrition state at admission, where 42.9% had plasma levels below the reference prealbumin. Amino acid profile was situated below the reference values and 99% of patients had low plasma transferrin. Significant differences were observed in total protein, ferritin and transferrin parameters adjusted by CRP levels, being higher when patients presented high inflammation in the case of ferritin and the opposite for the rest of parameters. Adjusting APACHE and SOFA scores according to low, medium and high severity, results showed significant differences in creatinine, urea, and transferrin, being lower at high severity grade for the last one. CONCLUSION: critical illness is characterized by a high degree of stress and accelerated degradation of proteins that cause malnutrition, systemic inflammation and organ dysfunction, with a significant association between albumin, ferritin and transferrin.

Antecedentes: el trauma y las infecciones severas causan cambios metabólicos notables en los pacientes con SRIS como una respuesta adaptativa dirigida a controlar la enfermedad subyacente, la reparación del tejido dañado y para sintetizar sustratos. Si el ataque es intenso y sostenido y el paciente tiene un estado nutricional comprometido puede evolucionar a insuficiencia orgánica múltiple y muerte. Objetivo: evaluación del estado nutricional proteico y la participación de las proteínas y los factores inflamatorios en pacientes críticamente enfermos. Método: estudio analítico observacional multicéntrico en pacientes enfermos críticos en la admisión en la UCI. Resultados y discusión: los pacientes mostraron alteraciones en los parámetros nutricionales clínicos que confirman su situación hipercatabólica, mostrando malnutrición a la admisión en UCI, donde el 42,9% tenían niveles plasmáticos de prealbúmina por debajo de la referencia. Los aminoácidos se encuentran por debajo de los valores de referencia y el 99% de los pacientes presentaron bajos niveles plasmáticos de transferrina. Se observaron diferencias significativas en los niveles de proteína total, ferritina y transferrina ajustados por los niveles de PCR, siendo mayor cuando los pacientes presentaron altos valores de inflamación, en el caso de la ferritina, y lo opuesto para el resto de parámetros. Al estratificar por las puntuaciones APACHE y SOFA de acuerdo a la gravedad baja, media y alta, los resultados mostraron diferencias significativas en creatinina, urea y transferrina, siendo menor cuanto mayor era el grado de severidad para la transferrina. Conclusión: la enfermedad crítica se caracteriza por un alto grado de estrés y la degradación acelerada de proteínas que causan malnutrición, inflamación sistémica y la disfunción de órganos, con una asociación significativa entre albúmina, ferritina y transferrina.

A Population-Based Ultra-Widefield Digital Image Grading Study for Age-Related Macular Degeneration-Like Lesions at the Peripheral Retina.

PURPOSE: Our understanding of the relevance of peripheral retinal abnormalities to disease in general and in age-related macular degeneration (AMD) in particular is limited by the lack of detailed peripheral imaging studies. The purpose of this study was to develop image grading protocols suited to ultra-widefield imaging (UWFI) in an aged population. DESIGN: A cross-sectional study of a random population sample in which UWFI was introduced at the 12-year review of the Reykjavik Eye Study in Iceland. PARTICIPANTS: Five hundred seventy-six subjects 62 years of age or older. METHODS: Ultra-widefield (up to 200°) color and autofluorescence images were obtained using the Optos P200CAF laser scanning ophthalmoscope (Optos plc, Dunfermline, Scotland). The images were graded at Moorfields Eye Hospital Reading Centre primarily based on the International Classification for AMD. Macular and peripheral changes were graded using a standardized grid developed for this imaging method. MAIN OUTCOME MEASURES: Presence or absence of hard, crystalline, and soft drusen; retinal pigment epithelial changes; choroidal neovascularization (CNV); atrophy; and hypoautofluorescence and hyperautofluorescence were graded in the peripheral retina. RESULTS: Of the eyes examined, 81.1% had AMD-like changes in the macula alone (13.6%), periphery alone (10.1%), and both periphery and macula (57.4%). There was no AMD-like CNV or pigment epithelial detachment in the periphery except in those cases in which these clearly originated from the macula. Seven patients had AMD-like atrophy in the periphery without end-stage disease in the macula. One patient with end-stage disease in the macula had normal periphery results on the color images. While analyzing the eyes, we detected pathologic appearances that were very reliably identified by graders. CONCLUSIONS: Phenotyping the retinal periphery using the categories defined by the International Classification confirmed the presence of wide-ranging AMD-like pathologic changes even in those without central sight-threatening macular disease. Based on our observations, we propose here new, reliably identifiable grading categories that may be more suited for population-based UWFI.

Association between magnesium-deficient status and anthropometric and clinical-nutritional parameters in posmenopausal women.

BACKGROUND: During menopause occurs weight gain and bone loss occurs due to the hormone decline during this period and other factors such as nutrition. Magnesium deficiency suggests a risk factor for obesity and osteoporosis. OBJECTIVE: To evaluate the clinical and nutritional magnesium status in a population of postmenopausal women, assessing intake and serum levels of magnesium in the study population and correlation with anthropometric parameters such as body mass index (BMI) and body fat, and biochemical parameters associated. SUBJECTS AND METHOD: The study involved 78 healthy women aged 44-76, with postmenopausal status, from the province of Grenade, Spain. The sample was divided into two age groups: group 1, aged < 58, and group 2 aged ≥ 58. Anthropometric parameters were recorded and nutritional intake was assessed by 72-hour recall, getting the RDAs through Nutriber® program. To assess the biochemical parameters was performed a blood sample was taken. Magnesium was analyzed by flame atomic absorption spectrophotometry (FAAS) in erythrocyte and plasma wet-mineralized samples. RESULTS: Our results show that 37.85% of the total subjects have an overweight status. Magnesium intake found in our population is insufficient in 36% of women, while plasma magnesium deficiency corresponds to 23% of the population and 72% of women have deficient levels of magnesium in erythrocyte. Positive correlations were found between magnesium intake and dietary intake of calcium, of phosphorus, and with prealbumin plasma levels, as well as with a lower waist / hip ratio. Magnesium levels in erythrocyte were correlated with lower triglycerides and urea values. CONCLUSION: It is important to control and monitor the nutritional status of magnesium in postmenopausal women to prevent nutritional alterations and possible clinical and chronic degenerative diseases associated with magnesium deficiency and with menopause.

Introducción: Durante la menopausia se produce un aumento de peso y de pérdida de masa ósea debido a la disminución hormonal producida durante este periodo y a otros factores como la nutrición. La deficiencia de magnesio podría ser un factor de riesgo para la obesidad y la osteoporosis. Objetivo: Evaluar el estado clínico-nutricional en una población de mujeres postmenopáusicas, evaluando la ingesta y los niveles séricos de magnesio, y su correlación con parámetros antropométricos, como el índice de masa corporal (IMC) y la grasa corporal, así como con parámetros bioquímicos asociados. Sujetos y Metodología: En el estudio participaron 78 mujeres sanas en situación de postmenopausia de la provincia a de Granada, con edades comprendidas entre los 44-76 años. La muestra se dividió en dos grupos de edad: grupo 1, mujeres postmenopáusicas con edad menor de 58 años y grupo 2, de edad mayor o igual a 58 años. Se registraron parámetros antropométricos y se valoró la ingesta nutricional mediante recordatorio de 72 horas, obteniendo las RDAs a través del programa Nutriber®. Para valorar los parámetros bioquímicos se realizó una extracción de sangre y el magnesio se analizó mediante espectrofotometría de absorción atómica de llama (FAAS) en muestras de eritrocitos y plasma previamente mineralizadas por vía húmeda. Resultados: Nuestros resultados muestran que el 37.8% de las mujeres presentan sobrepeso. La ingesta de magnesio encontrada en nuestra población es insuficiente en el 36% de las mujeres, mientras que la deficiencia de magnesio plasmático y eritrocitario corresponde al 23% y el 72% de las mujeres, respectivamente. Se observaron correlaciones significativas positivas entre el aporte de magnesio en la dieta y el aporte de calcio, de fósforo, y los niveles plasmáticos de prealbúmina, además de con una menor relación cintura/cadera. Los niveles de magnesio en eritrocito se correlacionaron con los niveles de triglicéridos y con menores valores de urea. Conclusión: Es importante un control y seguimiento de la situación nutricional en magnesio d la mujer postme nopáusica para prevenir alteraciones clínico-nutricionales y posibles enfermedades crónico-degenerativas relacionadas con la deficiencia del magnesio y la menopausia.

Agreement between time-domain and spectral-domain optical coherence tomography in the assessment of macular thickness in patients with idiopathic macular telangiectasia type 2.

PURPOSE: To estimate the conversion factors to transpose macular thickness measurements on time-domain (TD) to various spectral-domain (SD) optical coherence tomography (OCT) machines in patients with macular telangiectasia type 2a (MacTel). PROCEDURES: Macular scans on TD- and SD-OCT were performed on patients at the same visit. The retinal thickness values in various ETDRS subfields and macular volume were compared between different OCT machines. RESULTS: The macular thickness and volume were significantly greater (p < 0.0001, r = 0.678-0.822) on SD-OCT. The mean differences in macular thickness between TD Stratus and SD-OCT by Spectralis, Cirrus and Topcon were 62, 41 and 20 µm, respectively. The conversion factor of macular thickness from TD-OCT to Spectralis, Cirrus and Topcon were +65, +39 and +25 µm, respectively. CONCLUSION AND MESSAGE: The estimates of conversion of macular thickness from TD- to SD-OCT using simple mean differences between machines and those by linear regression were similar suggesting that the former may be used for the longitudinal follow-up of MacTel patients.

Implementation of a nutrition education program in a handball team; consequences on nutritional status.

OBJECTIVE: To evaluate nutritional status and dietary habits after implementation of a nutritional education program in professional handball players. RESEARCH METHODS AND PROCEDURES: Longitudinal study of 14 handball players evaluated with 72-h recall, a questionnaire on food consumption and anthropometric measures during 4 months. The intervention consisted of a nutrition education program. RESULTS: Energy intake was consistently below the recommended allowances. Macronutrient intakes as a percentage of total energy intake were below the recommended allowances for carbohydrates, and above recommended allowances for fats. Nutritional education was followed by a significant increase (p < 0.01) in total energy and macronutrient intakes, with no significant changes in macronutrient or micronutrient intakes after adjustment for energy intake. DISCUSSION: The imbalance in nutrient intake in handball players suggests that detailed re-analysis is needed to determine specific recommendations for this population. Nutritional education with continuous follow-up to monitor athletes' dietary habits may lead them to adopt appropriate nutritional habits to optimize dietary intakes. The lack of specific recommendations for micronutrient intakes in athletes leads to confusion regarding appropriate intakes; biochemical tests that yield normal values (albeit approaching cut-off values for deficiency) may disguise deficient status for some nutrients when strenuous exercise is involved. CONCLUSION: In-depth studies with nutrition education programs that include long-term follow-up are advisable to avoid deficiencies that can lead to irreversible damage in competitive athletes.

Objetivos: Evaluar el estado nutricional y los hábitos dietéticos en respuesta a la aplicación de un programa de educación nutricional en jugadores profesionales de balonmano. Sujetos y metodología: Estudio longitudinal realizado a una muestra de 14 jugadores pertenecientes a un equipo de balonmano de alto rendimiento, a los que se les evaluó mediante recordatorio de 72 horas, un cuestionario de frecuencia de consumo, medidas antropométricas a lo largo de 4 meses, y a los que se les aplicó un programa de educación nutricional al inicio del estudio. Los valores de ingesta y de frecuencia de consumo fueron comparados con las recomendaciones de macronutrientes existentes para deportistas y micronutrientes para población sana, respectivamente, y con la pirámide de alimentos para población sana española. Resultados: La ingesta de energía de los deportistas se situó por debajo de las recomendaciones a lo largo de todo el estudio. La ingesta de macronutrientes respecto a la energía ingerida, se situó por debajo de las recomendaciones para la ingesta de carbohidratos y por encima de las recomendaciones para la ingesta de grasa, mostrada en los resultados obtenidos de frecuencia de consumo de alimentos. La educación nutricional produjo un incremento significativo (p < 0,01) en la ingesta de energía y macronutrientes tras su aplicación. A pesar de ello, no se produjeron cambios significativos en la ingesta de macronutrientes y micronutrientes al ajustar por energía ingerida. Los niveles bioquímicos se encontraron dentro de los rangos de normalidad durante todo el estudio. Discusión: El desequilibrio en la ingesta de nutrientes presente en los jugadores de balonmano hace necesario realizar un ajuste nutricional completo para poder establecer recomendaciones específicas para este tipo de población. La aplicación de un programa de educación nutricional monitorizada de manera continuada mediante seguimiento en los deportistas, puede tener como consecuencia la instauración de hábitos nutricionales adecuados que lleve a una optimización en la ingesta. La ausencia de recomendaciones específicas de micronutrientes en el deporte, provoca una cierta confusión a la hora de establecer una ingesta adecuada de micronutrientes, ya que en muchos casos demuestran normalidad en los niveles bioquímicos, aunque muy cercanos a la deficiencia, pudiendo comprometer el estatus de algún nutriente en situaciones de ejercicio extremo. Conclusión: Sería aconsejable realizar estudios exhaustivos de valoración del estatus nutricional que planteen la instauración de programas de educación nutricional a largo plazo, con el fin de evitar carencias que deriven en daños irreversibles en el deportista de competición.

Characterization of L-cysteine capped CdTe quantum dots and application to test Cu(II) deficiency in biological samples from critically ill patients.

The catalytic activity of copper ion gives, from the physiological point of view, a central role in many biological processes. Variations in the composition and location of cellular copper have been addressed given their physiological and pathological consequences. In this paper L-cysteine capped CdTe quantum dots is used for the fluorimetric determination of Cu(II) in biological samples from healthy individuals and patients admitted to the Intensive Care Units (ICU). An acceptable homogeneity in the CdTe QDs size has been obtained with an average value of 3 nm. No significant alterations in the spectral properties were observed for 2 months when stored in vacutainers at 6°C and a concentration of approximately 2 µM. Data from oxidative stress markers such superoxide dismutase, total antioxidant capacity and DNA damage can be correlated with a Cu(II) deficiency for the ICU patients as measured by flame-atomic absorption spectroscopy (FAAS) and inductively coupled plasma source mass spectrometry (ICP-MS). Aqueous solutions 0.3 µM of L-cysteine capped CdTe QDs in MOPS buffer (6 mM, pH 7.4) used at 21°C in the range 15-60 min after preparation of the sample for the measurements of fluorescence gives contents in Cu(II) for erythrocytes in good agreement with those obtained in FAAS and ICP-MS but the comparative ease of use makes the fluorimetric technique more suitable than the other two techniques for routine analysis.

Effect of folic acid supplementation on homocysteine concentration and association with training in handball players.

BACKGROUND: Strenuous physical activity can alter the status of folic acid, a vitamin directly associated with homocysteine (Hcy); alterations in this nutrient are a risk factor for cardiovascular disease. Handball players are a population at risk for nutrient deficiency because of poor dietary habits. OBJECTIVE: The aims of this study were to evaluate nutritional status for macronutrients and folic acid in members of a high-performance handball team, and determine the effect of a nutritional intervention with folic acid supplementation and education. DESIGN: A total of 14 high-performance handball players were monitored by recording training time, training intensity (according to three levels of residual heart rate (RHR): <60%, 60%-80% and >80%), and subjective perceived exertion (RPE) during a 4-month training period. Nutritional, laboratory and physical activity variables were recorded at baseline (Week 0), after 2 months of dietary supplementation with 200 µg folic acid (50% of the recommended daily allowance) (Week 8) and after 2 months without supplementation (Week 16). We compared training load and analyzed changes in plasma concentrations of Hcy before and after the intervention. RESULTS: Bivariate analysis showed a significant negative correlation (P < 0.01) between Hcy and folic acid concentrations (r = -0.84) at Week 8, reflecting a significant change in Hcy concentration (P < 0.05) as a result of hyperhomocysteinemia following the accumulation of high training loads. At Week 16 we observed a significant negative correlation (P < 0.01) between Hcy concentration and training time with an RHR <60%, indicating that aerobic exercise avoided abrupt changes in Hcy and may thus reduce the risk of cardiovascular accidents in high-performance athletes. CONCLUSION: Integral monitoring and education are needed for practitioners of handball sports to record their folic acid status, a factor that directly affects Hcy metabolism. Folic acid supplementation may protect athletes against alterations that can lead to cardiovascular events related to exertion during competition.

Association between erythrocyte concentrations of magnesium and zinc in high-performance handball players after dietary magnesium supplementation.

Currently, research on athletes focuses on optimizing the nutritional status in order to adjust their minerals requirements. This study was designed to evaluate baseline nutritional status and the effect of a nutritional intervention based on magnesium (Mg) supplementation, on plasma and erythrocyte concentrations of Mg and zinc (Zn), and their relationship with training load. We analyzed training load by recording the training volume, intensity and rating of perceived exertion (RPE) during a four-month period, in 14 high-performance handball players. Intensity was studied in different levels of residual heart rate (RHR). We analyzed nutrient intake and plasma and erythrocyte concentrations of Mg and Zn by FAAS. All biomarkers were measured at baseline, after two months of dietary supplementation with Mg, and after two months without supplementation. RPE was associated with training volume at different intensities of RHR. Mg supplementation significantly increased plasma Mg levels during the supplemented period and preserved for subsequent changes in the non-supplemented period. Erythrocyte concentrations of Mg and Zn show associations between baseline and Mg supplementation. Mg levels were associated with training volume at different intensities after supplementation. In conclusion, our findings in high-performance handball players show that during competition, there is a relationship between erythrocyte Zn and Mg levels, regardless of Mg supplementation or Zn intake. Mg dietary supplementation tended to preserve changes in mineral levels during training and competition.