'Fat but powerful' paradox: association of muscle power and adiposity markers with all-cause mortality in older adults from the EXERNET multicentre study.

OBJECTIVES: To assess the influence of muscle power and adiposity on all-cause mortality risk and to evaluate the 'fat but powerful' (F+P) (or 'fat but fit') paradox in older adults. METHODS: A total of 2563 older adults (65‒91 years old) from the EXERNET multicentre study were included. Adiposity (body mass index (BMI), waist circumference, body fat percentage (BF%) and fat index), allometric and relative power (sit-to-stand muscle power test) and various covariates (age, sex, hypertension, smoking status and walking and sitting times per day) were registered at baseline. All-cause mortality was recorded during a median follow-up of 8.9 years. Participants were classified into four groups: lean and powerful (L+P), F+P, lean but weak and fat and weak (F+W). Cox proportional hazard regression models and adjusted HRs were calculated. RESULTS: According to BMI and waist circumference, all-cause mortality risk was reduced in the F+P (HR=0.55 and 0.63, p=0.044 and 0.049, respectively) and L+P (HR=0.57 and 0.58, p=0.043 and 0.025, respectively) groups. According to BF%, all-cause mortality decreased in the L+P group (HR=0.53; p=0.021), and a trend for a reduction was reported in the F+P group (HR=0.57; p=0.060). According to fat index, a survival benefit was only noted in the L+P group (HR=0.50; p=0.049). Higher levels of relative power reduced all-cause mortality risk among older people (HR=0.63 and 0.53, p=0.006 and 0.011, respectively). CONCLUSION: Powerful older people exhibited a reduced 9-year all-cause mortality regardless of BMI, waist circumference and BF%. Obesity according to fat index blunted the survival benefits of being powerful.

Evaluación de la tasa de blastocistos euploides en fase folicular y lútea (DuoStim) en mujeres con pobre respuesta ovárica: estudio preliminar en México / Euploid blastocyst rate in follicular vs luteal phase (DuoStim) in women with poor ovarian response: Preliminary study in Mexico

Resumen: OBJETIVO: Comparar la tasa de blastocistos euploides obtenida después de la estimulación ovárica en fase folicular con la fase lútea en un mismo ciclo menstrual en pacientes con deficiente respuesta ovárica. MATERIALES Y MÉTODOS: Estudio clínico, prospectivo y comparativo llevado a cabo en el Centro de Reproducción Arcos, Nascere, entre los meses de enero a julio de 2019. Se incluyeron pacientes con pobre respuesta ovárica según los criterios de Bologna y con indicación de PGT-A. Las estimulaciones en fase folicular y lútea se efectuaron con antagonista de la GnRH y FSHr/LHr (2:1) a partir del día 3 del ciclo y 5 días después de la primera recuperación de los ovocitos. Para completar el proceso de maduración ovocitaria se utilizaron análogos de GnRH, se tomó una biopsia de trofoectodermo en día 5-7. RESULTADOS: Se estudiaron 20 pacientes. Al comparar la fase folicular con la lútea la tasa de fertilización fue de 79% (IC95%: 29-46) vs 55% (IC95%: 34-53), la tasa de blastocistos 42% (IC95%: 19-44) vs 45% (IC95%: 24-55) y la tasa de blastocistos euploides 100% (IC95%: 44-53) vs 70% (IC95%: 38-46), respectivamente. Solo la tasa de recuperación de ovocitos en metafase II mostró diferencias significativas entre ambas fases 40% (IC95%: 18-37) vs 59% (IC95%: 31-59), p = 0.0333 en la fase folicular y lútea, respectivamente. CONCLUSIONES: La estimulación ovárica bifásica (folicular-lútea), en el mismo ciclo menstrual (DuoStim), resultó en mayor tasa de recuperación de ovocitos en metafase II durante la fase lútea. Sin embargo, las tasas de desarrollo embrionario a día 5-6 (blastocistos) y de embriones euploides fueron similares entre ambas fases.

Abstract: OBJECTIVE: Euploid blastocyst rate comparison between ovarian stimulation in follicular vs luteal phase performed in the same menstrual cycle in patients with poor ovarian response. MATERIALS AND METHODS: Clinical, prospective and comparative study conducted at Centro de Reproducción Arcos S.C., "Nascere", during january-july, 2019. Patients with PGT-A indication and poor ovarian response according to Bologna criteria were included. Under a short GnRH-antagonist protocol, stimulations, both in follicular and luteal phase were performed using rFSH/rLH (2:1) from day 3 of the cycle and 5 days after the first oocyte retrieval. In addition, ovulation trigger with an GnRH agonist was used, finally, on day 5-6 of embryo development, trophoctoctoderm biopsy was performed. RESULTS: In this study, 20 patients were included; when comparing follicular phase vs luteal phase, we found that fertilization rate was 79% (95%CI 29-46) vs 55% (95%CI 34-53), blastocysts rate was 42% (95%CI 19-44) vs 45% (95%CI 24-55) and euploid embryo rate was 100% (95%CI 44-53) vs 70% (95%CI 38-46). Only the oocyte recovery rate in metaphase II showed significant differences between both phases 40% (IC 95% 18-37) vs 59% (IC 95% 31-59), p=0.0333. CONCLUSION: Biphasic ovarian stimulation (follicular/ luteal) in the same menstrual cycle (DuoStim) resulted in a higher metaphase II ooctye recovery rate during the luteal phase in comparison with the follicular phase. However, the rates of blastocysts and euploid blastocysts were similar between both phases.

Diagnóstico genético preimplantacional no invasivo; datos preliminares en México / Non-invasive preimplantation genetic diagnosis; preliminary data in Mexico

Resumen: OBJETIVO: Analizar las tasas de concordancia, falsos positivos y negativos entre el ADN embrionario circulante en medio de cultivo y su relación con los reportes de la biopsia de trofoectodermo. MATERIALES Y MÉTODOS: Estudio observacional, prospectivo y comparativo, llevado a cabo en el Centro de Reproducción Arcos Nascere en noviembre 2018. Criterios: de inclusión: parejas en esquema de fertilización in vitro, con diagnóstico genético preimplantacional de aneuploidias. Criterios de exclusión: pacientes con anomalías estructurales o enfermedades monogénicas. Criterio de eliminación: blastocistos con eclosión asistida. Variables de respuesta: tasa de concordancia, falsos positivos y negativos entre las biopsias de trofoectodermo y los medios de cultivo. El análisis estadístico se realizó con SPSS 25.0, con pruebas t de Student y χ2 con valor de p < 0.05 significativa. RESULTADOS: Se analizaron 20 blastocistos de 5 parejas y se obtuvieron resultados informativos de 17 (amplificación global exitosa); 70% en día 5 y 100% en día 6. La tasa general de concordancia entre las biopsias de trofoectodermo y los medios de cultivo fue de 68.7% (42.8% en día 5 y 88.8% en día 6). En cuanto a las discrepancias, solo se observaron 2 falsos negativos en los medios de cultivo vs la biopsia de trofoectodermo (14.2% en día 5 y 11.11% en día 6); hubo 3 casos de falsos positivos (la mitad en día 5 y ninguno en día 6-7). CONCLUSIONES: Con la prueba genética no invasiva de aneuploidias se alcanzaron altas tasas de concordancia, sobre todo en embriones en día 6.

Abstract: OBJECTIVE: Analyze the concordance, false positive and false negative rates between circulating free DNA of the culture media compared to the results of the trophectoderm biopsy. MATERIALS AND METHODS: Observational, prospective and comparative study, conducted at Arcos Reproduction Center S.C. Nascere in november 2018. Couples with indication of preimplantation genetic diagnosis of aneuploidies undergoing In vitro Fertilization were included; carriers of structural anomalies or monogenic diseases were excluded and blastocysts with assisted hatching were eliminated. The response variables were the concordance, false positives and false negatives rates between trophoctoctoderm biopsies and culture media. Statistical analysis was performed with SPSS 25.0, using t-Student and chi-square tests with a value of p <0.05 significant. RESULTS: Informative results were obtained in 17 of the 20 culture media (85% successful global amplification); 70% on day 5 and 100% on day 6. The general concordance rate between trophectoderm biopsies and culture media was 68.7% (42.8% on day 5 and 88.8% on day 6). Regarding discrepancies, only 2 false negatives were observed in the culture media compared to the trophectoderm biopsy (14.2% on day 5 and 11.1% on day 6). There were 3 cases false positives (42.8% on day 5 and 0% on day 6). CONCLUSIONS: High rates of concordance were reached with the non-invasive genetic aneuploidy test, mainly in embryos on day 6.

Efecto en los resultados reproductivos con la "magnetic-actived cell sorting (MACS)" para la eliminación de espermatozoides positivos a anexina V en parejas con infertilidad inexplicable / Effect on reproductive outcomes by using "magnetic-actived cell sorting (MACS)" for the elimination of sperm-positive annexin-V in couples with unexplained infertility

Resumen Objetivo: Determinar si la eliminación de espermatozoides positivos a marcadores tempranos de apoptosis en parejas con infertilidad inexplicable incrementa la tasa de nacidos vivos. Materiales y métodos: Ensayo piloto, con asignación al azar, controlado y triple ciego; y un estudio paralelo de dos grupos. Se incluyeron parejas con diagnóstico de infertilidad inexplicable que se asignaron en una proporción 1:1 al grupo A (método de capacitación espermática swim-up) o grupo B (método de capacitación espermática swim-up complementado con separación magnética de células activadas; magnetic-actived cell sorting; MACS). Posteriormente, a todas las muestras se les efectuó una inyección intracitoplasmática de espermatozoides, como técnica de fertilización. Por último, todos los embriones obtenidos se analizaron hasta la etapa de blastocisto y todas las transferencias se llevaron a cabo en la misma etapa. Resultados: Se incluyeron 40 parejas y no se encontraron diferencias en la tasa de fertilización. Con la aplicación de MACS se obtiene mayor porcentaje de embriones de buena calidad en día 3 (90.3 vs 99.5%; p = 0.03) y en día 5 (77.3 vs 90.1%; p = < 0.0001) disminuyó el porcentaje de embriones arrestados (16.3 vs 7.9%; p = 0.01). Por último, las tasas de implantación (42.1 vs 57.1%), embarazo clínico (60 vs 80%) y nacidos vivos (55 vs 80%) aumentaron, sin diferencias estadísticamente significativas. Conclusiones: La separación magnética de células activadas (MACS) en parejas con infertilidad inexplicable mejora el desarrollo embrionario. A pesar de no existir una diferencia significativa se observa una tendencia al incremento de embarazos clínicos y nacidos vivos.

Abstract Objective: To determine if the live births delivery rate with the eliminating sperm positive to early apoptotic events is higher in couples with unexplained infertility. Materials and methods: A pilot randomized controlled trialA pilot and triple-blinded; using a parallel study of two groups. We included a total of 40 couples with unexplained infertility assigned in a 1:1 proportion either to the group A (sperm training method swim-up) or to the group B (swim-up sperm training method supplemented with the use of "magnetic-actived cell sorting (MACS)"). Subsequently, all samples were submitted to intracytoplasmic sperm injection as a fertilization technique. Finally, all embryos obtained were analyzed until the blastocyst stage, and all the transfers were performed in the same stage. Results: There are no differences in the fertilization rate; however, with the use of "magnetic-actived cell sorting" there is a higher percentage of good quality embryos on day 3 (90.3% vs 99.5%, p = 0.03) and day 5 (77.3% vs 90.1%, p = <0.0001). In addition, a decrease in the percentage of arrested embryos was demonstrated (16.3% vs 7.9%, p = 0.01). Finally, implantation (42.1% vs 57.1%), clinical pregnancy (60% vs 80%) and live birth rates (55% vs 80%) increased; however, no statistically significant differences were reported. Conclusions: The use of "magnetic-actived cell sorting" in couples with unexplained infertility improves embryonic development. Although there is no significant difference, a trend is observed in relation to the increase in the number of clinical pregnancies and live births.

Influence of Exposure to Chronic Persistent Low-Dose Ionizing Radiation on the Tumor Biology of Clear-Cell Renal-Cell Carcinoma. An Immunohistochemical and Morphometric Study of Angiogenesis and Vascular Related Factors.

Increased angiogenesis is related to boosted growth and malignancy in carcinomas. "Chronic Persistent Low-Dose Ionizing Radiation" (CPLDIR) exposure increases incidence and aggressive behavior of clear-cell renal-cell carcinoma (CCRCC). The aim was to study the biology of angiogenesis, including microvessel density (MVD), in human clear-cell renal-cell carcinomas (CCRCC) originating from a radio-contaminated geographical area (Ukraine) and to compare with similar tumors diagnosed in non-contaminated regions of Europe (Spain, Valencia) and Latin America (Colombia, Barranquilla). MVD was comparatively examined in 124 patients diagnosed with CCRCC from three geographical areas by means of digital micro-imaging and computerized analysis. Additionally, 50 adult normal kidneys were used for controls (autopsy kidneys from Valencia and Barranquilla). Furthermore, an immunohistochemical study of several vascular related growth factors was undertaken using a similar methodology. MVD as well as VEFG are the most discriminating factors associated with an aggressive behavior of CCRCC. Their expression increased in proportion to the level of exposure to chronic low-dose ionizing radiation in Ukrainian patients in the 25 years since the Chernobyl accident substantiated by comparison with the two control groups of renal carcinomas present in non-irradiated areas (Spain and Colombia). No major biological differences relating to angiogenesis appear to exist between the CCRCC diagnosed in two distant geographical areas of the world. HIF-1α expression was similar in all groups, with no statistical significance. Present findings demonstrate the existence of a significant relationship between MVD and VEGF in CCRCC: an increased expression of VEGF is associated with a high level of angiogenesis.

Revisión de tema: Biomarcadores neuronales y gliales como estrategia de clasificación cuantitativa de la severidad del trauma craneoencefálico / Review: Neuronal and glial biomarkers as quantitative approach to classify the severity of traumatic brain injury

Resumen Se ha puesto de relieve el potencial de la evaluación neurológica temprana inexacta de la severidad en pacientes con trauma craneoencefálico, ya que en algunos subgrupos de pacientes la gravedad de la lesión puede ser sobreestimada y en otros subestimada, lo cual ha llevado a la búsqueda de biomarcadores asociados a la lesión cerebral temprana. La investigación en este campo ha aumentado de forma exponencial en los últimos 20 años, con la mayoría de las publicaciones sobre el tema en los últimos 10 años, evidenciando diferentes resultados, que van desde hallazgos prometedores a otros no concluyentes. Un biomarcador ideal debería poder demostrar una alta sensibilidad y especificidad para la lesión cerebral, entre otros aspectos. En la actualidad no se cuenta con un biomarcador único capaz de predecir el deterioro clínico de los pacientes que presente tanto una alta sensibilidad como especificidad; en lugar de ello se debe disponer de un panel de marcadores que reflejen diferentes aspectos de la injuria traumática. Este trabajo presenta una revisión sobre los biomarcadores más prometedores como predictores de severidad del trauma craneoencefálico, explorando su naturaleza, ubicación a nivel encefálico, sus concentraciones basales, su vida media y los métodos por los cuales estos pueden ser cuantificados una vez atraviesan la barrera hematoencefálica.

Abstract It has been highlighted the potential of early neurological inaccurate assessment of severity in patients with head trauma; in some cases, for example, the severity of the injury is overestimated or underestimated. The aforementioned situation has led to the search of biomarkers associated with early brain injury. Research in this field has exponentially increased over the past 20 years, with a higher publication ramp in the last 10 years. The results range from promising findings to other sometime inconclusive. An ideal biomarker should be able to demonstrate high sensitivity and specificity for brain injury, among others aspects. Literature has shown that there is not a single biomarker that can predict patient's clinical decline with high sensitivity and specificity correlation. Instead, it is required to use a panel of markers that reflect different aspects of traumatic brain injury. In this paper, we conducted a review of the most promising biomarkers studied as predictors of severity of head trauma, with special focus on their nature, location, basal concentrations, blood half-life and methods by which they can be quantified in blood samples.

[Physical fitness evolution in octogenarian population and its relationship with a sedentary lifestyle]. / Evolución de los niveles de condición física en población octogenaria y su relación con un estilo de vida sedentario.

OBJECTIVE: The aim of this study was to determine the changes in physical fitness over two years of following up in octogenarian people and to check whether a sedentary lifestyle modify these variations. METHODS: Physical fitness of 182 subject (48 men, 134 women) with a mean age of 82,3 ± 2,3 years were evaluated using 8 different tests. A repeated measures analysis was carried out to see the differences between the two evaluation periods and to see the physical fitness differences between sedentary people (sit ≥ 4 hours/day) and non sedentary people (sit < 4 hours/day). RESULTS: Between the two evaluation periods, we found a significant decrease in the agility test (p < 0.05), walking speed (p < 0.01) and endurance (p < 0.01). In relation to the subjects who spent sitting 4 hours/day there was a decrease in the walking speed test between the two evaluations (p < 0.05). Moreover, there was a decrease of walking speed and endurance between the two evaluation periods in both sedentary and nonsedentary people (p < 0.05). CONCLUSION: In two years of following up, there are adverse changes in the level of physical fitness in octogenarians. Long periods of sitting time may translate into a loss of agility. Walking speed and endurance seem to be the components of physical fitness more affected by the ageing process in this population; and this loss is not determined by the hours of sitting per day.

Objetivos: Determinar los cambios que se producen en la condición física a lo largo de dos años de seguimiento en octogenarios y comprobar si un estilo de vida sedentario modifica estas variaciones. Metodología: La condición física de 182 sujetos (48 hombres, 134 mujeres) con una media de edad de 82,3 ± 2,3 años se evaluó mediante 8 test (adaptados de las baterías "Senior Fitness Test" y "Eurofit"). Se realizó un análisis de medidas repetidas entre los dos periodos de evaluación y para ver las diferencias de condición física entre los sujetos considerados sedentarios (permanecían sentados ≥4 horas/día) y no sedentarios (permanecían sentados < 4 horas/día) Resultados: Entre las dos evaluaciones encontramos un descenso significativo en los test de agilidad (p < 0,05), velocidad (p < 0,01) y resistencia (p < 0,01) y un ligero aumento de la fuerza de brazos en los sujetos que permanecían sentados < 4 horas/día (p < 0,05). Aquellos que permanecían sentados > 4 horas/día sufrieron un descenso de la agilidad (p < 0,05). Se produjo una pérdida de velocidad y resistencia tanto en sedentarios como en no sedentarios (p < 0,05). Conclusión: En dos años de seguimiento, se producen cambios negativos en el nivel de condición física en personas octogenarias. Periodos prolongados de sedestación se traducen en una pérdida de agilidad. La velocidad de la marcha y resistencia parecen ser los componentes de la condición física más afectados por el proceso de envejecimiento en este grupo poblacional y su pérdida no viene determinada por las horas diarias de sedestación.

Energy consumption, body composition and physical activity levels in 11- to 13-year-old Spanish children.

BACKGROUND/AIMS: The prevalence of overweight and obesity in childhood is increasing markedly. The aim of this study was to evaluate the relationship between physical activity, energy consumption and weight status in a cohort of Spanish children. METHODS: A total of 137 children (11-13 years old) participated in the study voluntarily (with paternal consent). Children were classified into 3 groups according to their physical activity, i.e. sedentary, active and sporty groups. Body composition measures, physical fitness and total caloric and macronutrient intake were determined. RESULTS: Weight, body mass index, waist circumference, skinfold thickness measures and body fat percentage of children were lower in the active children, whereas body water content increased with activity. Nutritional habits were similar in the 3 studied groups. No significant differences in total energy intake or percentage of carbohydrates, fat and proteins were found. All parameters related to caloric expenditure were higher in children carrying out more physical activity. CONCLUSIONS: Children with higher levels of physical activity presented more favorable anthropometric profiles, but there were no differences in respect to their dietary habits. An increase in weekly energy expenditure through physical activity outside school seems essential to prevent overweight and the risk of childhood obesity.

[Sarcopenic obesity and physical fitness in octogenarians: the multi-center EXERNET Project]. / Obesidad sarcopénica y condición física en octogenarios; proyecto multi-céntrico EXERNET.

OBJECTIVE: The aim of this study was to analyze the usefulness of different fitness test to detect the risk of sarcopenic obesity (SO) in octogenarian people. METHODS: 306 subjects (76 men, 230 women) with a mean age of 82.5 ± 2.3 years from the Multi-center EXERNET Project sample fulfilled the inclusion criteria. Body composition was assessed in all subjects by bioelectrical impedance. Four groups were created based on the percentage of fat mass and muscle mass: 1) normal, 2) high fat mass, 3) low muscle mass and 4) SO. Physical fitness was assessed using 8 different tests modified from the batteries "Senior Fitness Test" and Eurofit (EXERNET battery). The risk of suffering SO depending on the fitness level was studied by logistic regression. RESULTS: Among the studied physical fitness tests, those that better predicted the risk of SO were leg strength, arm strength, agility, walking speed and balance in men; 95% CI [(0.606-0.957) (0.496-0.882), (0.020-2.014), (0.17-1.39), (0.913-1.002), all p < 0.05, except balance test (p = 0.07)] and balance test and agility in women; (95% CI [(0.928-1.002) (0.983-1.408), (both p = 0.07)]. CONCLUSION: Adequate levels of physical fitness are associated with a lower risk of SO. Some easy fitness tests seem to be useful for the detection of SO in those cases where the body-composition required methods for diagnosis are not available.

Objetivo: El objetivo de este estudio fue analizar la utilidad de diferentes test de condición física para detectar el riesgo de sufrir obesidad sarcopénica (OS) en octogenarios. Métodos: 306 sujetos (76 hombres, 230 mujeres) con una media de edad de 82,5±2,3 años, del total de la muestra del Proyecto Multi-céntrico EXERNET cumplieron con los criterios de inclusión. La composición corporal se evaluó en todos los sujetos mediante impedancia bioeléctrica. Se crearon 4 grupos basados en el porcentaje de masa grasa y masa muscular: 1) normal, 2) elevada masa grasa, 3) baja masa muscular y 4) OS. La condición física fue evaluada utilizando 8 test diferentes adaptados de las baterías "Senior Fitness Test" y "Eurofit" (batería EXERNET). La probabilidad de padecer OS en función del nivel de condición física se estudió mediante regresión logística. Resultados: Entre las pruebas de condición física estudiadas, los test que mejor predecían el riesgo de sufrir OS fueron la falta de fuerza de piernas, fuerza de brazos, agilidad, velocidad y equilibrio en hombres; 95% CI [(0,606-0,957); (0,496-0,882); (1,116-3,636); (1,060-1,825); (0,913-1,002); todos p.

Physical activity and cardiovascular risk factors in Spanish children aged 11-13 years.

INTRODUCTION AND OBJECTIVES: The prevalence of childhood obesity has increased in recent decades. The aim was to determine whether a 3-month intervention on daily physical activity at school could affect body weight and cardiovascular risk factors associated with childhood obesity. METHODS: A total of 137 children (12[1] years old) volunteered to participate in an observational cross-sectional study. Children were allowed to join one of the following groups: a) sedentary group (2h/week of physical education at school); b) active group (2h/week of physical education at school plus 3h/week extra physical activity), and c) sports group (2h/week of physical education at school plus 5h/week extra physical activity). Anthropometric characteristics, blood pressure, physical condition (estimated by the Course-Navette test), and biochemical parameters related with cardiovascular risk factors were determined. RESULTS: Body weight, body mass index, waist circumference, sum of skinfold thickness, body fat percentage, and fat mass index of children were decreased with high physical activity level, whereas body water content significantly increased with activity. Parameters related with cardiovascular risk -triglycerides, insulin, systolic blood pressure, and homeostatic model assessment index- presented lower values in the sports group. Maximal oxygen uptake and maximum heart rate (Course Navette test) progressively increased with activity. Children participating in a total of 7h/week of physical activity presented significantly lower odds ratio of having high levels of the following cardiovascular risk factors: waist circumference, fat mass index, and homeostatic model assessment index. CONCLUSIONS: Physical activity is important for metabolic health in children. Children with higher levels of physical activity presented better anthropometric and biochemical profiles.

Effects of AM3 (Inmunoferon) on increased serum concentrations of interleukin-6 and tumour necrosis factor receptors I and II in cyclists.

The aims of this study were to examine the changes in plasma concentrations of inflammatory cytokines induced by training and competition in professional cyclists. We report the serum concentrations of interleukin-6 (IL-6), tumour necrosis factor alpha (TNF-a), tumour necrosis factor receptors I and II (TNFR-I and -II) in a prospective, randomized, double-blind trial involving the administration of AM3 (Inmunoferon), an oral booster immunomodulator, or placebo to 16 professional cyclists (n = 8 in each group) for 65 consecutive days. Serum was collected just before treatment began (baseline), at the end of pre-competition training, before the mountain stage of the competition (60 days), 4 h after finishing this stage (62 days), and 18 h after the fifth and last day of competition (65 days). To determine the normal levels of cytokines and soluble TNF receptors, individual samples from 14 moderately trained healthy controls were studied. After 60 days of training, the serum concentrations of IL-6 did not differ significantly from those at the beginning of the study for either group of cyclists (placebo and AM3). A significant rise was seen in IL-6 concentrations in both the AM3 and placebo groups at 62 days, 4 h after finishing the mountain stage. The increase was significantly greater in the placebo group than in the AM3 group. At 65 days of treatment, 18 h after the fifth and last day of competition, IL-6 concentrations were similar to those recorded at the end of the training, but were significantly higher in the placebo group than in the AM3 group. At the end of training, serum TNFR-I concentrations in both groups of cyclists were significantly lower than at baseline. The concentrations of serum TNFR-I and -II both 4 h after finishing the mountain stage and 18 h after the fifth and last day of competition were significantly higher than those recorded after training in both groups. Professional cycling competition is associated with increases in serum IL-6 and TNFR-I and -II concentrations. Inmunoferon treatment reduced significantly the concentrations of IL-6 but not those of TNFR-I and -II.

[Effect of intramural and subserous myomas on in vitro fertilization cycles and their perinatal results]. / Efecto de los miomas intramurales y subserosos en los ciclos de fertilización in vitro y sus resultados perinatales.

OBJECTIVE: To evaluate the effect of intramural and subserous myomas in in vitro fertilization cycles, as well as its perinatal results. TYPE OF STUDY: Cases and controls. MATERIAL AND METHODS: All the IVF cycles between October 1999 and December 2004 were included. The variables of size and type of myomas, as well as variables of IVF cycles, implantation and pregnancy rates, and perinatal results were analyzed. We calculated the chi-square test to analyze the relationship between myomas and pregnancy. The t-Student test was used to establish the difference in the average between both groups regarding the studied variables. In the logistic regression analysis we controlled confusing variables. RESULTS: We analyzed 431 cycles made in 364 patients divided into two groups: study cases (with myomas-65 cycles) and control cases (without myomas-366 cycles). Age was two years older in the study group (35.7 vs 33.5, p < 0.001). There was no difference in: duration, type of infertility, days of stimulation, gonadotrophin dose, total and mature follicles, and fertilization and implantation rates. We only observed a difference in the recovered oocytes (8.0 vs 9.7, p = 0.027). The pregnancy, abortion and live-born children rates were of 20.0 vs 23.2, 46.1 vs 29.4, and 46.1 vs 58.8%, respectively (study and control groups; p > 0.05). Logistic regression showed that myomas do not affect the possibility of getting pregnant. CONCLUSION: Intramural and subserous myomas < 5 cm do not seem to have an effect in the IVF cycles nor in its perinatal results. In women with myomas < 5 cm that no dot distortion the uterine cavity it is questionable the usefulness of a myomectomy prior to IVF cycles.

Increased lymphocyte antioxidant defences in response to exhaustive exercise do not prevent oxidative damage.

It has been reported that exercise induces oxidative stress and causes adaptations in antioxidant defences. The aim of this study was to determine the adaptations of lymphocytes to the oxidative stress induced by an exhaustive exercise. Nine voluntary male subjects participated in the study. The exercise was a cycling mountain stage (171.8 km), and the cyclists took a mean of 283 min to complete it. Blood samples were taken the morning of the cycling stage day, after overnight fasting, and 3 h after finishing the stage. We determined the blood glutathione redox status (GSSG/GSH), lymphocyte antioxidant enzyme activities and superoxide dismutase (SOD) levels; the plasma and lymphocyte vitamin E levels; the serum lactate dehydrogenase (LDH) and creatine kinase (CK) activities and urate levels; the plasma carotene and malonaldehyde (MDA) levels; and the lymphocyte carbonyl index. The cycling stage induced significant increases in blood-oxidized (glutathione/GSSG), plasma MDA and serum urate levels. The exercise also produced increases in CK and LDH serum activities. The mountain cycling stage induced significant increases in lymphocyte vitamin E levels, glutathione peroxidase and glutathione reductase activities as well as increased SOD activity and protein levels. The protein carbonyl levels increased significantly in lymphocytes after the stage. In conclusion, in spite of increasing antioxidant defences in response to the oxidative stress induced by the exhaustive exercise, lymphocyte oxidative damage was produced after the stage as demonstrated by the increased carbonyl index even in very well trained athletes.

Hand strike-induced hemolysis and adaptations in iron metabolism in Basque ball players.

INTRODUCTION: Basque ball players (BBPs) make repeated hand strikes to the ball which involves continuous mechanical trauma. OBJECTIVE: The aim of this work is to describe the hematological variations and changes in iron metabolism occurring in BBPs as a result of acute and continuous practice of this special sport native to Northern Spain. METHODS: 40 healthy male subjects volunteered to participate in this study: 11 subjects who exercise moderately (control group) but do not play Basque ball sport and 29 professional BBPs were studied in two situations: before a match (BM group) and after a match (AM group). The following hematological parameters were determined: red blood cell count (RBC), hemoglobin and hematocrit; MCV, MCH and MCHC. The following variables were measured in serum: iron, ferritin, transferrin, transferrin saturation, proteins, and lactate dehydrogenase (LDH). Proteins and hemoglobin were determined in urine. RESULTS: The BM group showed lower hematocrit, MCV, hemoglobin and serum transferrin levels, and higher LDH than controls. The AM group showed higher RBC, hemoglobin, serum proteins, iron, transferrin and LDH levels, lower plasma volume, and higher urine hemoglobin and protein levels than the BM group. CONCLUSIONS: Basque ball playing induces hemolysis and increases the plasma capability to quench free iron, but its clinical consequences on iron metabolism do not seem to be enough to take an iron intake proportional to the caloric intake. In order to prevent, in the long term, the development of anemia in these peculiar sportsmen, it would be useful that medical teams observe urine blood losses and oxidative stress in these BBPs.

[Prognostic factors of pregnancy in intrauterine insemination]. / Factores pronóstico de embarazo en inseminación intrauterina.

BACKGROUND: The artificial insemination is the introduction of spermatozoa in the feminine genital tract without carrying out sexual contact and with the purpose of obtaining the pregnancy. The insemination intrauterine has improved its rate of success thanks to the technological advances and the best knowledge of human reproductive physiology. OBJECTIVES: To evaluate the prognostic factors for the pregnancy success and calculate the cumulative rate per cycle in IUI (intrauterine insemination). PATIENTS AND METHODS: This study was descriptive, retrospective, analytic, and longitudinal. The cycles of IUI were analyzed from January 1st 2003 to December 31st 2005. Couples 24-41 years old with primary and secondary infertility were included. The following variables were studied: age of participant, type of infertility, length of infertility, aetiology, postcapacitation sperm density and motility, number of follicles, endometrial thickness, and the cycle number in which the IUI was performed. Patients carried out a protocol of ovarian stimulation and follicular follow up. The results were analyzed with 11.0 SPSS, continuous variables were analyzed and reported as means +/- SD with univariate logistic regression to determine statistic significance. Categoric variables were reported in frequencies and percentages. ROC curves were calculated to determine optimal cutting points. RESULTS: 668 cycles were analyzed in 391 couples. The pregnancy rate per cycle and couple was of 13.0 and 21.7% respectively. Means +/- SD patient age was 33.5 +/- 3.4 years old. The three variables with p < 0.05 were: the infertility duration, sperm motility and the cycle number in which IUI was performed. No statistical significance was found in the remaining variables. CONCLUSIONS: The greatest success in IUI will be achieved with infertility of 4 years or less, with sperm motility of 77.6% and in the first two cycles of treatment.

Antioxidant diet supplementation influences blood iron status in endurance athletes.

OBJECTIVE: The aim of this work was to check the effects of antioxidant supplementation (vitamins E and C, and beta-carotene) on the basal iron status of athletes prior to and following their training and competition season (3 months). DESIGN: Eighteen amateur trained male athletes were randomly distributed in 2 groups: placebo (lactose) and antioxidant supplemented (vitamin E, 500 mg/d; vitamin C, 1 g/d; and beta -carotene, 30 mg/d). The study was double blind. Hematological parameters, dietary intake, physical activity intensity, antioxidant status (GSH/GSSG ratio), and basal iron status (serum iron, transferrin, ferritin, and iron saturation index) were determined before and after the intervention trials. RESULTS: Exercise decreased antioxidant defenses in the placebo group but not in the antioxidant-supplemented group. No changes were found in the number of erythrocytes, hematocrit, or hemoglobin concentration, or in values of serum iron parameters, after taking the antioxidant cocktail for 3 months, in spite of the exercise completed. The placebo group showed a high oxidative stress index, and decreases in serum iron (24%) and iron saturation index (28%), which can neither be attributed to aspects of the athletes' usual diet, nor to hemoconcentration. CONCLUSIONS: Antioxidant supplementation prevents the decrease of serum iron and the iron saturation index, and a link between iron metabolism and oxidative stress may also be suggested.

[Estrogen role in the luteal phase support in in vitro fertilization with embryo transfer cycles]. / Papel de los estrógenos en el soporte de la fase lútea en ciclos de fertilización in vitro con transferencia de embriones.

OBJECTIVE: To evaluate the effectiveness of estradiol administration for luteal phase support and to describe the progesterone and estradiol behavior in vitro fertilization-embryo transfer luteal phase. MATERIAL AND METHODS: Patients undergoing in vitro fertilization-embryo transfer with controlled ovarian hyperstimulation and using gonadotropin releasing hormone agonist. They were divided at random into two groups: group 1 would receive progesterone alone, and group 2 would take estrogen and progesterone. Serum concentrations of estradiol and progesterone were measured on days 7 and 14 post-embryo transfer. RESULTS: We examined 52 patients; 24 received progesterone alone and 28 took estrogen and progesterone. Significantly higher estradiol and progesterone concentrations on day 14 were found in pregnant women. It was not on day 7. A significant increment of estrogen was found in the estrogen and progesterone group. Progesterone did not increase significantly. Pregnancy rate was the same in both groups. CONCLUSIONS: For patients undergoing in vitro fertilization-embryo transfer, the addition of estradiol to the progesterone support regimen does not have beneficial effects in terms of pregnancy rate. On day 7 neither progesterone nor estradiol are good predictors of pregnancy.

Effect of exercise intensity and training on antioxidants and cholesterol profile in cyclists.

The aim of this work was to evaluate the effect of different intensity of exercise and different training status on antioxidants and cholesterol profile in cyclists. 33 male cyclists (17 amateur and 16 professional cyclists) participated in this study. The amateurs all trained 14 +/- 1 h each week, and their VO(2) max was 62.5 +/- 1.8 ml/Kg x min; the professionals all trained 24 +/- 1 h each week, and their VO(2) max was 80.2 +/- 1.6 ml/Kg x min. Amateurs were submitted to the maximal and submaximal prolonged exercise tests. Professionals were submitted to a mountain stage (170 km) of cycling competition. Serum lipid and cholesterol profile (triglycerides, total cholesterol, HDL-cholesterol, LDL-cholesterol and VLDL-cholesterol) and plasma antioxidant capacity (ascorbic acid, alpha-tocopherol, retinol, beta-carotene and others) were measured before and after exercise tests. Hematological determinations (number of erythrocytes, hematocrit and hemoglobin concentration) and dietary intake were also measured. No significant differences were observed in basal values (before exercise tests) of amateur and professional cyclists. Negligible differences were found between dietary intake of amateur and professional cyclists, and also the results of hematological values showed there was no effect of degree of hydration or dietary intake on blood levels of studied antioxidant and lipid parameters. An increase in plasma levels of vitamin C, vitamin E, triglycerides and VLDL-cholesterol levels, and also a decrease of beta-carotene and LDL-cholesterol. were observed in well-trained professional cyclists after the cycling stage - an endurance exercise--but not in amateur cyclists. Amateur cyclists showed only mild increases in total cholesterol after maximal and submaximal exercise, while a rise in HDL-cholesterol was only observed after maximal exercise; none of these changes were observed in professional cyclists. Plasma levels of antioxidant vitamins and carotenes, and also serum lipids, total cholesterol and lipoprotein-cholesterol showed an overall response to exercise, and their increase and/or decrease must be explained as a consequence of the different training status of sportsmen and intensity and duration of exercise tests.

[Pelvic surgery as a predictive marker of the follicular response to ovulation inducers]. / La cirugía pélvica como un marcador predictivo de la respuesta folicular a los inductores de ovulación.

OBJECTIVE: Comparing the follicular response in a group of patients with previous pelvic surgery submitted to in vitro fertilization. MATERIAL AND METHODS: Patients who were going to be submitted to controlled ovarian stimulation and in vitro fertilization were included. Two groups were formed: one with those patients who had had a previous pelvic operation and the other with those patients who had not. The characteristics which were analyzed included: age, weight, body mass index, FSH, LH and estradiol levels, as well as total ova numbers, grade of embryonic maturity, and number of transferred embryos. RESULTS: Ninety nine patients were studied: 46 had been submitted to pelvic surgery and 53 had not. Due to the design of the study there were no differences regarding age, weight, size and body mass index; the evaluation of the ovarian reserve was similar in both groups. However, the group of patients previously submitted to pelvic surgery presented a lower quantity of total ova (p = 0.004), less mature ova (p = 0.008) with a significantly lower pregnancy rate. CONCLUSIONS: Surgical procedures, combined with adherence processes, probably have a direct incidence on the characteristics of the perifollicular environment which interfere with adequate development of the ovum. All these can be observed in a decrease of fertilization processes and embryonic development, regardless of the expression of the adequate biochemical markers of the ovarian reserve. Our research shows that the group under study presents a decrease in follicular response affecting the quality of the ovum-embryo expressed in the pregnancy rate.

La cirugÝa pÚlvica como un marcador predictivo de la respuesta folicular a los inductores de ovulación / Pelvic surgery as a predictive marker of the follicular response to ovulation inducers

OBJECTIVE: Comparing the follicular response in a group of patients with previous pelvic surgery submitted to in vitro fertilization. MATERIAL AND METHODS: Patients who were going to be submitted to controlled ovarian stimulation and in vitro fertilization were included. Two groups were formed: one with those patients who had had a previous pelvic operation and the other with those patients who had not. The characteristics which were analyzed included: age, weight, body mass index, FSH, LH and estradiol levels, as well as total ova numbers, grade of embryonic maturity, and number of transferred embryos. RESULTS: Ninety nine patients were studied: 46 had been submitted to pelvic surgery and 53 had not. Due to the design of the study there were no differences regarding age, weight, size and body mass index; the evaluation of the ovarian reserve was similar in both groups. However, the group of patients previously submitted to pelvic surgery presented a lower quantity of total ova (p = 0.004), less mature ova (p = 0.008) with a significantly lower pregnancy rate. CONCLUSIONS: Surgical procedures, combined with adherence processes, probably have a direct incidence on the characteristics of the perifollicular environment which interfere with adequate development of the ovum. All these can be observed in a decrease of fertilization processes and embryonic development, regardless of the expression of the adequate biochemical markers of the ovarian reserve. Our research shows that the group under study presents a decrease in follicular response affecting the quality of the ovum-embryo expressed in the pregnancy rate.