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1.
Zhonghua Yu Fang Yi Xue Za Zhi ; 57(9): 1364-1372, 2023 Sep 06.
Artigo em Chinês | MEDLINE | ID: mdl-37743296

RESUMO

Objective: To investigate the species, concentration and seasonal trends of main airborne allergenic pollen in 4 districts and 5 counties of Hohhot City. Methods: The Department of allergy, Beijing Shijitan Hospital Affiliated to Capital Medical University conducted a cross-sectional study about monitoring the airborne allergenic pollen from August 1, 2021 to July 31, 2022 by the gravitational method in 4 districts and 5 counties of Hohhot City, which include Yuquan District, Xincheng District, Huimin District, Saihan District, Tuoketuo County, Helingeer County, Tumotezuoqi County, Wuchuan County and Qingshuihe County. Daily pollens were counted and identified by optical microscopy, and the data were analyzed. Results: The airborne allergenic pollen was collected every month all year round in 4 districts and 5 counties of Hohhot city. Through the whole year of the total quantity of pollens ranged from 24 850 to 50 154 grains per 1 000 mm2 and two peaks of pollen concentration in air were observed,which happened in spring (from March to May) and in summer and autumn (from July to September). In spring, the main pollens were tree pollens, which principally distributed in Populus pollen (18.29%), Ulmus pollen (8.36%), Pinus pollen (6.20%), Cupressaceae pollen (5.23%), Betulaceae pollen (2.73%), Salix pollen (1.80%) and Quercus pollen (1.16%). In summer and autumn, the main pollens were weed pollens, which mainly included Artemisia pollen (42.73%), Chenopodiaceae pollen or Amaranthaceae pollen (7.46%), Poaceae pollen (2.26%), Humulus pollen or Cannabis pollen (0.60%). Conclusion: There were two peaks of main airborne allergenic pollen in 4 districts and 5 counties of Hohhot City. In the spring peak of pollen, the main airborne pollens were tree pollens. In the summer and autumn peak of pollen, the main airborne pollens were weed pollens. The Artemisia pollen was the most major airborne pollen in this area.


Assuntos
Hospitais , Pólen , Humanos , Estudos Transversais
2.
Artigo em Chinês | MEDLINE | ID: mdl-35527440

RESUMO

Objective: To investigate the sensitization characteristics of Juniperus chinensis pollen in patients with allergic rhinitis and/or allergic asthma in Beijing area, and to explore the characteristics of Juniper chinensis pollen sensitized population. Methods: Patients with suspected allergic rhinitis and/or asthma from January 2017 to December 2019 in the outpatient department of Allergy Department of Beijing Shijitan Hospital were selected in this study. Skin prick test (SPT) was performed with Juniper chinensis pollen allergen reagent to compare different age and disease allergen distribution, and to observe the sensitization characteristics of its population. All of the analyses were performed using SAS software version 9.4. Results: A total of 8 380 patients were enrolled in the end. The total positive rate of Juniper chinensis pollen SPT reached 49.92% (4 183/8 380). The positive rate of Juniper chinensis pollen SPT was highest in the 10-14 age group, reaching 60.99% (283/464). Compared with other age groups, there was a statistical difference (χ²=266.77, P<0.01). The SPT positive rate of patients aged less than 10 years increased with the increase of age, while the SPT positive rate of patients aged over 40 years decreased with the increase of age. Single Juniper chinensis pollen was less allergenic, accounting for about 25.05% (1 048/4 183), and the patients' age was (35.21±12.39) years. Regardless of single Juniper chinensis pollen or other pollen allergies, allergic rhinitis was the main disease. Among the patients with SPT positive Juniper chinensis pollen combined with other inhaled pollen allergens, willow pollen accounted for the first (74.99%). The positive rate of Juniper chinensis pollen was the highest in patients with single allergic rhinitis, accounting for 52.05% (3 797/7 295), and the rate in patients with single allergic asthma was the lowest, accounting for 17.49% (53/303), with statistically difference (χ²=138.99, P<0.01). Conclusions: Juniper chinensis pollen is highly sensitized in patients with allergic rhinitis and/or allergic asthma in Beijing . The positive rate of SPT is highest among 10-14 age group, most of which showed strong positive reaction, and allergic rhinitis is more common in Juniper chinensis pollen sensitization diseases.


Assuntos
Asma , Juniperus , Rinite Alérgica , Adolescente , Adulto , Alérgenos , Criança , Humanos , Pólen , Testes Cutâneos
3.
JAMA Pediatr ; 176(4): 365-372, 2022 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-35072694

RESUMO

IMPORTANCE: Mindfulness curricula can improve physician burnout, but implementation during residency presents challenges. OBJECTIVE: To examine whether a novel mindfulness curriculum implemented in the first 6 months of internship reduces burnout. DESIGN, SETTING, AND PARTICIPANTS: This pragmatic, multicenter, stratified cluster randomized clinical trial of a mindfulness curriculum randomized 340 pediatric interns to the intervention or control arm within program pairs generated based on program size and region. Fifteen US pediatric training programs participated from June 14, 2017, to February 28, 2019. INTERVENTIONS: The intervention included 7 hour-long sessions of a monthly mindfulness curriculum (Mindfulness Intervention for New Interns) and a monthly mindfulness refresher implemented during internship. The active control arm included monthly 1-hour social lunches. MAIN OUTCOMES AND MEASURES: The primary outcome was emotional exhaustion (EE) as measured by the Maslach Burnout Inventory 9-question EE subscale (range, 7-63; higher scores correspond to greater perceived burnout). Secondary outcomes were depersonalization, personal accomplishment, and burnout. The study assessed mindfulness with the Five Facet Mindfulness Questionnaire and empathy with the Interpersonal Reactivity Index subscales of perspective taking and empathetic concern. Surveys were implemented at baseline, month 6, and month 15. RESULTS: Of the 365 interns invited to participate, 340 (93.2%; 255 [75.0%] female; 51 [15.0%] 30 years or older) completed surveys at baseline; 273 (74.8%) also participated at month 6 and 195 (53.4%) at month 15. Participants included 194 (57.1%) in the Mindfulness Intervention for New Interns and 146 (42.9%) in the control arm. Analyses were adjusted for baseline outcome measures. Both arms' EE scores were higher at 6 and 15 months than at baseline, but EE did not significantly differ by arm in multivariable analyses (6 months: 35.4 vs 32.4; adjusted difference, 3.03; 95% CI, -0.14 to 6.21; 15 months: 33.8 vs 32.9; adjusted difference, 1.42; 95% CI, -2.42 to 5.27). None of the 6 secondary outcomes significantly differed by arm at month 6 or month 15. CONCLUSIONS AND RELEVANCE: A novel mindfulness curriculum did not significantly affect EE, burnout, empathy, or mindfulness immediately or 9 months after curriculum implementation. These findings diverge from prior nonrandomized studies of mindfulness interventions, emphasizing the importance of rigorous study design and suggesting that additional study is needed to develop evidence-based methods to reduce trainee burnout. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03148626.


Assuntos
Esgotamento Profissional , Internato e Residência , Atenção Plena , Esgotamento Profissional/prevenção & controle , Esgotamento Profissional/psicologia , Esgotamento Psicológico , Criança , Currículo , Feminino , Humanos , Atenção Plena/educação , Atenção Plena/métodos , Inquéritos e Questionários
4.
Artigo em Chinês | MEDLINE | ID: mdl-34011001

RESUMO

Objective: To analyze the clinical characteristics of Chenopodiaceae pollen induced seasonal allergic rhinitis (SAR) as well as the distribution and sensitization characteristics of Chenopodiaceae pollen in Inner Mongolia grassland of northern China. Methods: From May 2015 to August 2015, using stratified, cluster and random sampling, a field interviewer-administered survey study and skin prick test (SPT) were conducted in six areas of Inner Mongolia grassland (Xilinhot, Erenhot, Duolun, Tongliao, Jarud, Kailu), and pollen monitoring was carried out in the above six areas from January 1 to December 31 of 2015. The clinical characteristics of Chenopodiaceae pollen induced SAR, distribution and sensitization characteristics of Chenopodiaceae pollen in these regions were observed. SAS software 9.4 was used for data processing. Results: A total of 6 043 subjects completed the study. The prevalence of Chenopodiaceae pollen induced SAR was 13.2% (795/6 043). The highest prevalence was found in the 18-39 age group. Subjects from urban areas showed higher prevalence of SAR than rural areas (61.2% vs 37.9%, P<0.001). There was significant regional difference in the prevalence rate of Chenopodiaceae pollen induced SAR among the above six areas (Xilinhot 21.5%, Erenhot 17.8%, Duolun 8.9%, Tongliao 6.9%, Jarud 15.3%, Kailu 9.7%, P<0.001). The main clinical symptoms of Chenopodiaceae pollen induced SAR were sneezing (96.5%) and nasal itching (92.2%). Eye itching was more obvious among the ocular symptoms (69.1%), while fatigue (32.1%) and drowsiness (31.5%) were more prominent among other related symptoms. Among comorbidities of Chenopodiaceae pollen induced SAR, allergic conjunctivitis accounted for 71.4% (568/795), food allergy accounted for 86.7% (689/795) and asthma accounted for 16.7% (133/795). The peak of Chenopodiaceae pollen spread was in August. The prevalence of Chenopodiaceae pollen induced SAR was positively correlated with the concentration of Chenopodiaceae pollen (R2=0.78, P=0.043). The SPT positive rate of Chenopodiaceae pollen was 21.2% (1 282/6 043), and Xilinhot had the highest rate in six regions (28.0%, 236/842). Conclusions: The prevalence of Chenopodiaceae pollen induced SAR in Inner Mongolia grassland stays at a high level. Sneezing is the most obvious symptom of SAR. The peak of Chenopodiaceae pollen spread is in August and the prevalence of Chenopodiaceae pollen induced SAR is positively correlated with the pollen concentration.


Assuntos
Chenopodiaceae , Rinite Alérgica Sazonal , Alérgenos , China/epidemiologia , Pradaria , Humanos , Pólen , Rinite Alérgica Sazonal/epidemiologia
5.
Zhonghua Yan Ke Za Zhi ; 56(5): 325-329, 2020 May 11.
Artigo em Chinês | MEDLINE | ID: mdl-32450664

RESUMO

The recent years has witnessed the fast growing number of cataract patients with diabetes mellitus (DM). The complexity and diversity of DM-related ocular complications has made the cataract treatment of such patients intractable and easily ignored. Cataract surgery has become an essential part of the comprehensive treatment of diabetic ophthalmopathy. Therefore, it is more necessary to implement proper perioperative management. In this article, we discuss the preoperative blood glucose control and the prevention of infective endophthalmitis. Moreover, the importance of ocular surface health and the strategy-making in the patients with diabetic retinopathy are elaborated. We also emphasize the details of surgical techniques and postoperative follow-up. We strive to create a holistic concept throughout the process of diagnosis and treatment with an individualized and standardized view, so that the concurrence of cataract and DM may not be a challenge in the future. (Chin J Ophthalmol, 2020, 56: 325-329).


Assuntos
Extração de Catarata , Catarata , Complicações do Diabetes , Diabetes Mellitus , Retinopatia Diabética , Endoftalmite , Oftalmopatias , Catarata/terapia , Humanos
6.
Zhonghua Wei Chang Wai Ke Za Zhi ; 22(11): 1021-1026, 2019 Nov 25.
Artigo em Chinês | MEDLINE | ID: mdl-31770832

RESUMO

Radiation-induced bowel injury is a common complication of radiation therapy for pelvic malignancy. Given the huge number of patients diagnosed with pelvic malignancy, the number of patients diagnosed with radiation-induced bowel injury increased year by year, which put a great burden on the clinical diagnosis and treatment of radiation-induced bowel injury. In particular, chronic radiation-induced bowel injury, which is manifested in the process of prolonged, repeated and progressive aggravation, seriously affects the physical and mental health of patients and makes clinical diagnosis and treatment difficult. However, due to insufficient attention and understanding from doctors and patients, standardized diagnosis and treatment of radiation-induced bowel injury still have a long way to go. Radiation-induced bowel injury is self-limited but irreversible. During diagnosis, we should pay attention to overall evaluation of the stage of disease based on clinical symptoms, endoscopic examination, imaging examination, pathology and nutritional risk. The treatment methods include health education, drug therapy, enema therapy, formalin local treatment, endoscopic treatment and surgical treatment, etc. The treatment decision-making should be based on clinical symptoms, endoscopic or imaging findings to alleviate the clinical symptoms of patients as the primary goal and to improve the long-term quality of life of patients as the ultimate goal.


Assuntos
Enteropatias/terapia , Neoplasias Pélvicas/radioterapia , Lesões por Radiação/terapia , Radioterapia/efeitos adversos , Doença Crônica , Humanos , Enteropatias/diagnóstico , Enteropatias/etiologia , Intestinos/efeitos da radiação , Qualidade de Vida , Lesões por Radiação/diagnóstico , Lesões por Radiação/etiologia
7.
J Dairy Sci ; 102(8): 7011-7025, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31155261

RESUMO

The objective of this study was to investigate the effect of one specific strain of yeast, Saccharomyces cerevisiae boulardii CNCM I-1079 (SCB), on the growth performance, health, and fecal bacterial profile of veal calves. A total of 84 animals were enrolled in an experiment at a commercial veal farm for a total of 7 wk. Calves were fed twice a day with a milk replacer meal during the entire experiment and were randomly assigned to receive daily either SCB supplementation (10 × 109 cfu/d) or a placebo (CON). Individual feed intake and body weight were monitored on a daily and weekly basis, respectively. Fecal samples were collected at arrival to the veal facility (wk 0) and additional samples were taken on d 14 (wk 2) and d 49 (wk 7). These samples were subjected to 16S rRNA gene amplicon sequencing using Illumina MiSeq (Illumina Inc., San Diego, CA) to examine the bacterial profiles and real-time quantitative PCR to quantify Saccharomyces cerevisiae and specific bacterial groups. The significant increase of S. cerevisiae in the feces of SCB calves at wk 2 and 7 compared with wk 0 (respectively 1.7 × 107, 1.2 × 107, and 2.2 × 105 copy number of S. cerevisiae/g of feces) indicates a good survival of that yeast strain along the gastrointestinal tract. Supplementation of SCB did not improve overall growth performance with regard to average daily gain (ADG), final body weight, and feed intake. Nevertheless, a total of 69.1% of nonsupplemented calves had diarrhea and 28.6% experienced severe diarrhea, whereas 50.0% of the calves supplemented with SCB had diarrhea and 9.5% experienced severe diarrhea. With respect to antibiotic use, 89.7% of the diarrheic calves recorded in the CON group were treated, whereas only 66.7% of the SCB diarrheic calves received an antibiotic. In addition, diarrheic calves supplemented with SCB maintained an ADG similar to nondiarrheic animals, whereas the CON diarrheic calves had a significantly lower ADG in comparison with nondiarrheic CON calves. Fecalibacterium was the most predominant bacterial genus in fecal samples of nondiarrheic and diarrheic calves supplemented with SCB, whereas fecal microbiota was predominated by Collinsella in diarrheic calves from the CON group. Live yeast supplementation in milk replacer led to a decrease of diarrhea in milk-fed veal calves and the fecal microbiota of diarrheic calves maintained a healthy community similar to nondiarrheic animals, with Fecalibacterium being the predominant genus.


Assuntos
Bactérias/classificação , Doenças dos Bovinos/microbiologia , Diarreia/veterinária , Suplementos Nutricionais/análise , Microbiota , Saccharomyces cerevisiae/fisiologia , Ração Animal/análise , Animais , Antibacterianos/uso terapêutico , Bactérias/genética , Peso Corporal/efeitos dos fármacos , Bovinos , Doenças dos Bovinos/tratamento farmacológico , Diarreia/tratamento farmacológico , Diarreia/microbiologia , Dieta/veterinária , Ingestão de Alimentos , Fezes/microbiologia , Trato Gastrointestinal/microbiologia
8.
J Dairy Sci ; 102(8): 7073-7086, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31202657

RESUMO

The present study investigated whether delaying the first feeding of colostrum affected ileum and colon mucosa-associated microbiota in calves. Twenty-seven male Holstein calves were randomly assigned to 1 of 3 groups, fed colostrum at 45 min, 6 h, and 12 h after birth, respectively. Ileum and colon mucosa were collected at 51 h after birth, and their associated microbial profiles were assessed using amplicon sequencing. Both ileum and colon mucosa-associated microbiota were predominated by genus Escherichia-Shigella. The negative correlation between the molar proportion of short-chain fatty acids (SCFA) and ileum mucosa-associated opportunistic pathogens, and the positive correlation between the molar proportion of SCFA and colon mucosa-associated beneficial bacteria, suggest that SCFA might play an important role in maintaining the gut health of 2-d-old calves. A higher relative abundance of ileum mucosa-associated Enterococcus and Streptococcus was detected when the first colostrum feeding was delayed for 12 h. The relative abundance of colon mucosa-associated Lactobacillus tended to be lower in calves fed colostrum 12 h than those under the other 2 treatments, whereas that of Faecalibacterium tended to be lower in calves fed colostrum immediately after birth than those fed colostrum 6 and 12 h after birth, respectively. Our findings suggest that delayed first colostrum feeding affects the establishment of ileum and colon mucosa-associated bacteria, which may have long-term effects on gut health of calves.


Assuntos
Animais Recém-Nascidos/microbiologia , Bovinos/microbiologia , Colostro/metabolismo , Ácidos Graxos Voláteis/análise , Microbioma Gastrointestinal , Animais , Animais Recém-Nascidos/fisiologia , Bovinos/fisiologia , Colo/microbiologia , Enterococcus/classificação , Enterococcus/crescimento & desenvolvimento , Escherichia/classificação , Escherichia/crescimento & desenvolvimento , Feminino , Íleo/microbiologia , Mucosa Intestinal/microbiologia , Masculino , Distribuição Aleatória , Shigella/classificação , Shigella/crescimento & desenvolvimento , Streptococcus/classificação , Streptococcus/crescimento & desenvolvimento , Fatores de Tempo
9.
Mucosal Immunol ; 11(4): 1230-1238, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29855550

RESUMO

Epigallocatechin-3-gallate (EGCG), a natural and major ingredient of green tea, has been shown to have anti-inflammation and anti-HIV-1 properties. We demonstrated that the intrarectal administration of EGCG could protect rhesus macaques from repetitive, intrarectal challenges with low-dose SHIVSF162P3N. This protection has a per-exposure risk reduction of 91.5% (P = 0.0009; log-rank test) and a complete protection of 87.5% (P < 0.001; Fisher's exact test). All protected animals showed no evidence of systemic and mucosal SHIV infection as demonstrated by the absence of viral RNA, DNA and antibodies. In contrast, all controls became infected after repeated SHIV challenges (a median of 2.5 times, range of 1-8 times). Mechanistically, EGCG could block the binding of HIV-1 gp120 to CD4 receptor and suppress the macrophage infiltration/activation in the rectal mucosa of macaques. These data support further clinical evaluation and development of EGCG as a novel, safe and cost-effective microbicide for preventing sexual transmission of HIV-1.


Assuntos
Antivirais/uso terapêutico , Catequina/análogos & derivados , Infecções por HIV/tratamento farmacológico , HIV-1/fisiologia , Macrófagos/efeitos dos fármacos , Síndrome de Imunodeficiência Adquirida dos Símios/tratamento farmacológico , Vírus da Imunodeficiência Símia/fisiologia , Animais , Antígenos CD4/metabolismo , Catequina/uso terapêutico , Movimento Celular , Transmissão de Doença Infecciosa , Proteína gp120 do Envelope de HIV/metabolismo , Humanos , Macaca , Macrófagos/imunologia , Macrófagos/virologia , Ligação Proteica/efeitos dos fármacos , Risco , Doenças Virais Sexualmente Transmissíveis , Chá
10.
Allergy ; 73(6): 1232-1243, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29322523

RESUMO

BACKGROUND: The aim of this study was to investigate the prevalence of epidemiologic and physician-diagnosed pollen-induced AR (PiAR) in the grasslands of northern China and to study the impact of the intensity and time of pollen exposure on PiAR prevalence. METHODS: A multistage, clustered and proportionately stratified random sampling with a field interviewer-administered survey study was performed together with skin prick tests (SPT) and measurements of the daily pollen count. RESULTS: A total of 6043 subjects completed the study, with a proportion of 32.4% epidemiologic AR and 18.5% PiAR. The prevalence was higher in males than females (19.6% vs 17.4%, P = .024), but no difference between the two major residential and ethnic groups (Han and Mongolian) was observed. Subjects from urban areas showed higher prevalence of PiAR than rural areas (23.1% vs 14.0%, P < .001). Most PiAR patients were sensitized to two or more pollens (79.4%) with artemisia, chenopodium, and humulus scandens being the most common pollen types, which were similarly found as the top three sensitizing pollen allergens by SPT. There were significant regional differences in the prevalence of epidemiologic AR (from 18.6% to 52.9%) and PiAR (from 10.5% to 31.4%) among the six areas investigated. PiAR symptoms were positively associated with pollen counts, temperature, and precipitation (P < .05), but negatively with wind speed and pressure P < .05). CONCLUSION: Pollen-induced AR (PiAR) prevalence in the investigated region is extremely high due to high seasonal pollen exposure, which was influenced by local environmental and climate conditions.


Assuntos
Alérgenos/imunologia , Exposição Ambiental/efeitos adversos , Pólen/imunologia , Rinite Alérgica Sazonal/epidemiologia , Rinite Alérgica Sazonal/imunologia , Adolescente , Adulto , Criança , Pré-Escolar , China/epidemiologia , Clima , Estudos Transversais , Feminino , Geografia Médica , Pradaria , Humanos , Imunização , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Rinite Alérgica Sazonal/diagnóstico , Testes Cutâneos , Adulto Jovem
11.
Reproduction ; 155(1): 37-49, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-29066528

RESUMO

This study aimed to determine if short-term nutrient alteration affects (1) ovarian morphology, (2) plasma and ovarian antioxidant capability and (3) cell apoptosis and AKT signaling within the ovary. After estrus synchronization, 24 Hu sheep were assigned to three groups based on the nutrient requirement recommended for maintenance (M): 1 × M (Control), 1.5 × M (S) and 0.5 × M (R) during days 7-14 of their estrous cycle. The results indicated that undernourishment significantly increased the counts and volume of follicles <2.5 mm and decreased the counts and volume of follicles ≥2.5 mm (P < 0.05). Feed restriction altered the plasma and follicular redox balance within follicles ≥2.5 mm by inhibiting total antioxidant capacity, increasing malondialdehyde concentration (P < 0.05) and reducing the mRNA expression levels of superoxide dismutase 2 (SOD2) and glutathione peroxidase (GSH-PX), as well as the activities of total SOD and GSH-PX. Feed restriction also attenuated B-cell lymphoma-2 (BCL2) but enhanced Bcl-2-associated X protein (BAX) and BAX/BCL2 transcription and translation levels in granulosa cells (P < 0.05). Uniform staining intensities of AKT and P-AKT-Ser473 were observed in each follicle stage, whereas weaker P-AKT-Thr308 staining in the antral follicle than in the pre-antral follicle suggested possible involvement of P-AKT-Thr308 during the beginning of follicle development. P-AKT-Ser473 levels in follicles ≥2.5 mm was significantly reduced in the R group (P < 0.05). The results presented in this study demonstrate that suppressed folliculogenesis caused by feed restriction might be associated with attenuated AKT signaling, reduced follicular antioxidant capacity and enhanced granulosa cells apoptosis.


Assuntos
Antioxidantes/metabolismo , Apoptose , Células da Granulosa/patologia , Folículo Ovariano/patologia , Proteínas Proto-Oncogênicas c-akt/metabolismo , Inanição , Animais , Ciclo Estral , Feminino , Células da Granulosa/metabolismo , Folículo Ovariano/metabolismo , Ovinos , Transdução de Sinais
12.
J Anim Physiol Anim Nutr (Berl) ; 100(5): 902-10, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27611109

RESUMO

This study was conducted to evaluate the efficacy and safety of dietary urea in sheep rations having a 50:50 concentrate:roughage ratio. Sixty-four Dorper × thin-tailed Han crossbred ram lambs with an average body weight of 30.8 (±0.02) kg were randomly divided into four groups of 16 sheep each, and each group was fed one of the following diets: a basal diet (CON), or CON supplemented with 0.5% (0.5UTM), 1.5% (1.5UTM) or 2.5% (2.5UTM) urea. Growth performance, carcass characteristics, non-carcass offals, meat quality and peptic tissue lesions were assayed. The average daily weight gains for CON, 0.5UTM, 1.5UTM and 2.5UTM were 216, 218, 200 and 170 g, respectively, with the CON and 0.5UTM groups higher than 2.5UTM group (p < 0.05). Sheep from the 2.5UTM treatment had a significantly lower dry matter intake (1.29 kg/day) than those from the CON and 0.5UTM treatments (1.42 and 1.43 kg/day, p < 0.05), and the feed conversion ratio in the 2.5UTM group was the highest (p < 0.05). Carcass characteristics, including shrunk body weight, empty body weight, hot carcass weight, dress percentage, and the absolute or relative weight (% body weight) of heart, liver, spleen, lung and kidney, were not altered by the treatments (p > 0.05). The muscular pH of 2.5UTM was higher than that of CON (5.68 vs. 5.52, p < 0.05), and shear force in 0.5UTM was lower compared with CON and 2.5UTM (p < 0.05). The anatomical structure lesions in kidneys became more serious with the increasing dietary urea concentrations, with the 2.5UTM animals showing the most severe lesions compared with CON animals. Therefore, supplementary urea as a non-protein nitrogen source for sheep should not exceed 1.5% of ration having a 50:50 concentrate:roughage ratio to ensure efficacy and safety.


Assuntos
Ração Animal/análise , Dieta/veterinária , Suplementos Nutricionais , Ovinos/fisiologia , Ureia/farmacologia , Fenômenos Fisiológicos da Nutrição Animal , Animais , Composição Corporal , Masculino , Carne/normas , Ureia/administração & dosagem
13.
J Anim Sci ; 94(5): 2072-85, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-27285704

RESUMO

This study was conducted with an ovine intrauterine growth restriction (IUGR) model to test the hypothesis that dietary -carbamylglutamate (NCG) and rumen-protected -Arg (RP-Arg) supplementation are effective in ameliorating fetal growth restriction in undernourished ewes. Beginning on d 35 of gestation, ewes were fed a diet providing 100% of NRC-recommended nutrient requirements, 50% of NRC recommendations (50% NRC), 50% of NRC recommendations supplemented with 20 g/d RP-Arg (providing 10 g/d of Arg), and 50% of NRC recommendations supplemented with 5 g/d NCG product (providing 2.5 g/d of NCG). On d 110, maternal, fetal, and placental tissues and fluids were collected and weighed. Ewe weights were lower ( < 0.05) in nutrient-restricted ewes compared with adequately fed ewes. Maternal RP-Arg or NCG supplementation did not alter ( = 0.26) maternal BW in nutrient-restricted ewes. Weights of most fetal organs were increased ( < 0.05) in RP-Arg-treated and NCG-treated underfed ewes compared with 50% NRC-fed ewes. Supplementation of RP-Arg or NCG reduced ( < 0.05) concentrations of ß-hydroxybutyrate, triglycerides, and ammonia in serum of underfed ewes but had no effect on concentrations of lactate and GH. Maternal RP-Arg or NCG supplementation markedly improved ( < 0.05) concentrations of AA (particularly arginine-family AA and branched-chain AA) and polyamines in maternal and fetal plasma and in fetal allantoic and amniotic fluids within nutrient-restricted ewes. These novel results indicate that dietary NCG and RP-Arg supplementation to underfed ewes ameliorated fetal growth restriction, at least in part, by increasing the availability of AA in the conceptus and provide support for its clinical use to ameliorate IUGR in humans and sheep industry production.


Assuntos
Arginina/farmacologia , Suplementos Nutricionais , Retardo do Crescimento Fetal/veterinária , Glutamatos/farmacologia , Ovinos/fisiologia , Ácido 3-Hidroxibutírico , Líquido Amniótico , Ração Animal , Fenômenos Fisiológicos da Nutrição Animal , Animais , Arginina/administração & dosagem , Dieta/veterinária , Feminino , Desenvolvimento Fetal , Glutamatos/administração & dosagem , Necessidades Nutricionais , Poliaminas , Gravidez , Fenômenos Fisiológicos da Nutrição Pré-Natal , Rúmen/metabolismo
14.
Osteoporos Int ; 27(2): 757-67, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26223190

RESUMO

UNLABELLED: The ultimate goal of osteoporosis treatment is prevention of fragile fracture. Local treatment targeting specific bone may decrease the incidence of osteoporotic fractures. We developed an injectable, thermosensitive simvastatin/poloxamer 407 hydrogel; a single CT-guided percutaneous intraosseous injection augmented vertebrae in ovariectomized minipigs. INTRODUCTION: The greatest hazard associated with osteoporosis is local fragility fractures. An adjunct, local treatment might be helpful to decrease the incidence of osteoporotic fracture. Studies have found that simvastatin stimulates bone formation, but the skeletal bioavailability of orally administered is low. Directly delivering simvastatin to the specific bone that is prone to fractures may reinforce the target bone and reduce the incidence of fragility fractures. METHODS: We developed an injectable, thermosensitive simvastatin/poloxamer 407 hydrogel, conducted scanning electron microscopy, rheological, and drug release analyses to evaluate the delivery system; injected it into the lumbar vertebrae of ovariectomized minipigs via minimally invasive CT-guided percutaneous vertebral injection. Three months later, BMD, microstructures, mineral apposition rates, and strength were determined by DXA, micro-CT, histology, and biomechanical test; expression of VEGF, BMP2, and osteocalcin were analyzed by immunohistochemistry and Western blots. RESULTS: Poloxamer 407 is an effective controlled delivery system for intraosseous-injected simvastatin. A single injection of the simvastatin/poloxamer 407 hydrogel significantly increased BMD, bone microstructure, and strength; the bone volume fraction and trabecular thickness increased nearly 150 %, bone strength almost doubled compared with controls (all P < 0.01); and induced higher expression of VEGF, BMP2, and osteocalcin. CONCLUSIONS: CT-guided percutaneous vertebral injection of a single simvastatin/poloxamer 407 thermosensitive hydrogel promotes bone formation in ovariectomized minipigs. The underlying mechanism appears to involve the higher expression of VEGF and BMP-2.


Assuntos
Vértebras Lombares/fisiopatologia , Osteogênese/efeitos dos fármacos , Osteoporose/tratamento farmacológico , Poloxâmero/administração & dosagem , Sinvastatina/administração & dosagem , Absorciometria de Fóton/métodos , Animais , Densidade Óssea/efeitos dos fármacos , Proteína Morfogenética Óssea 2/metabolismo , Físico-Química , Combinação de Medicamentos , Sistemas de Liberação de Medicamentos , Avaliação Pré-Clínica de Medicamentos/métodos , Feminino , Hidrogel de Polietilenoglicol-Dimetacrilato , Injeções Espinhais , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/metabolismo , Microscopia Eletrônica de Varredura , Osteoporose/diagnóstico por imagem , Osteoporose/fisiopatologia , Ovariectomia , Poloxâmero/química , Poloxâmero/farmacologia , Poloxâmero/uso terapêutico , Radiografia Intervencionista , Reologia , Sinvastatina/farmacologia , Sinvastatina/uso terapêutico , Suínos , Porco Miniatura , Tomografia Computadorizada por Raios X , Fator A de Crescimento do Endotélio Vascular/metabolismo
15.
J Anim Physiol Anim Nutr (Berl) ; 99(6): 1065-73, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26053391

RESUMO

The effect of long-term dietary supplementation with rutin on the lactation performance, ruminal fermentation and metabolism of dairy cows were investigated in this study. Twenty multiparous Chinese Holstein cows were randomly divided into four groups, and each was offered a basal diet supplemented with 0, 1.5, 3.0 or 4.5 mg rutin/kg of diet. The milk yield of the cows receiving 3.0 and 4.5 mg rutin/kg was higher than that of the control group, and the milk yield was increased by 10.06% and 3.37% (p < 0.05). On the basis of that finding, the cows supplemented with 0 or 3.0 mg rutin/kg of diet were used to investigate the effect of rutin supplementation on blood metabolites and hormone levels. Compared with the control group, the serum blood urea nitrogen (BUN) concentration of the 3.0 mg rutin/kg group is significantly decreased (p < 0.05). In another trial, four adult cows with permanent rumen fistula and duodenal cannulae were attributed in a self-control design to investigate the peak occurrence of rutin and quercetin in different parts of the gastrointestinal tract, ruminal fermentation and microbial population in dairy cows. The cows supplemented with 3.0 mg rutin/kg in the diet differed from the control period. Samples of rumen fluid, duodenal fluid and blood were collected at 1, 2, 3, 4, 5, 6, 7 and 8 h after morning feeding. Compared to the control group, the pH, ammonia nitrogen concentration, number and protein content of rumen protozoa and blood urea nitrogen were lower, but the concentration of total volatile fatty acid (TVFA), microbial crude protein (MCP) and serum lysozyme content were higher for the cows fed the rutin diets. The addition of 3.0 mg rutin/kg to diets for a long term tended to increase the milk yield and improve the metabolism and digestibility of the dairy cows.


Assuntos
Bovinos/fisiologia , Suplementos Nutricionais , Metabolismo Energético/efeitos dos fármacos , Lactação/efeitos dos fármacos , Rúmen/efeitos dos fármacos , Rutina/farmacologia , Ração Animal/análise , Fenômenos Fisiológicos da Nutrição Animal , Animais , Dieta/veterinária , Feminino , Fermentação , Lactação/fisiologia , Leite/química , Leite/fisiologia , Rúmen/fisiologia , Rutina/administração & dosagem
16.
J Anim Physiol Anim Nutr (Berl) ; 99(4): 676-83, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25319536

RESUMO

Two experiments were conducted to evaluate the effect of resveratrol on methanogenesis and microbial flora in Dorper × thin-tailed Han cross-bred ewes. In experiment 1, ten ewes (67.2 ± 2.24 kg BW) were assigned to two dietary treatments, a basal diet and a basal diet supplemented with resveratrol (0.25 g/head·day), to investigate the effect of resveratrol on nutrient digestibility and nitrogen balance. In experiment 2, six ewes (64.0 ± 1.85 kg BW) with ruminal cannulae were assigned to the identical dietary treatments used in experiment 1 to investigate supplementary resveratrol on ruminal fermentation and microbial flora using qPCR. The results showed that supplementary resveratrol improved the digestibility of organic matter (OM; p < 0.001), nitrogen (N; p = 0.007), neutral detergent fibre (NDF; p < 0.001) and acid detergent fibre (ADF; p < 0.001). The excretion of faecal N was reduced (p = 0.007), whereas that of urinary N increased (p = 0.002), which led to an unchanged N retention (p = 0.157). Both CO2 and CH4 output scaled to digestible dry matter (DM) intake decreased from 602.5 to 518.7 (p = 0.039) and 68.2 to 56.6 (p < 0.001) respectively. Ruminal pH (p = 0.341), ammonia (p = 0.512) and total volatile fatty acid (VFA) (p = 0.249) were unaffected by resveratrol. The molar proportion of propionate increased from 13.1 to 17.5% (p < 0.001) while that of butyrate decreased from 11.0 to 9.55% (p < 0.001). The ratio of acetate to propionate (A/P) decreased from 5.44 to 3.96 (p < 0.001). Supplementary resveratrol increased ruminal population of Fibrobacter succinogenes, Ruminococcus albus and Butyrivibrio fibrisolvens (p < 0.001) while decreased protozoa and methanogens. In conclusion, dietary resveratrol inhibited methanogenesis without adversely affecting ruminal fermentation.


Assuntos
Suplementos Nutricionais , Digestão/efeitos dos fármacos , Metano/metabolismo , Rúmen/microbiologia , Ovinos , Estilbenos/farmacologia , Ração Animal/análise , Fenômenos Fisiológicos da Nutrição Animal , Animais , Dieta/veterinária , Feminino , Resveratrol , Rúmen/efeitos dos fármacos , Estilbenos/administração & dosagem
17.
Farm Hosp ; 37(4): 276-85, 2013.
Artigo em Espanhol | MEDLINE | ID: mdl-24010688

RESUMO

OBJECTIVE: To identify and to promote improvements in the quality of the sanitary attention to the HIV+ patients in the Clinical Units of the hospitals in our country, there being included and reinforcing the perspective of Pharmaceutical Care. METHODS: To carry out the project, during the period January- June 2012, the following phases were defined. First, a bibliographical review was realized and reading criticizes related to the pathology HIV and quality criteria. Later, a presencial qualitative investigation phase was carried out with the expert participants. The first one was carried out by means of two technologies: the nominal group and a variant of groups of discussion. The application of the technologies was supported by an technical support that allowed the codification and valuation organized. The last phase of the project consisted of a meeting presencial, where there were outlined the aims of the first meeting and put jointly all the work that the subgroups of work had elaborated to agree on the contents. Of the first selection of ideas, the equipment of investigation worked and prioritized those elements that describe and give response to the raised aims. Concretely, the correct definition of the safety and quality indicators in the area of the hospital pharmacist, there being elaborated a card that was describing every aspect to bear in mind for the later measurement of the indicator. Finally, a plan of actions was elaborated to improve the clinical practice synthesized according to his level of priority. RESULTS: Across the methodology of the project, the experts identified the quality criterias in pharmaceutical care procedure. The principal barriers identified were: asistencial pressure, personnel management system's, security and ignorance of the pharmacotherapy, lack of quality culture and difficulties of access to the information. Principals clinical risks identified were: mistakes in the guidelines with the changes of treatments, lack of information of the whole medication of the patient, lack in resources and time adapted to realize the processes, lack of communication between professionals, ignorance of interactions or adverse events. The principal results that were extracted from the analysis of situation were that the priority line of action had to happen for a link between patients, specialists and primary care. It should promote the clinical management of the units of HIV, the access to the information for all the professionals who realize pharmacoterapeutical follow-up to these patients and the major implication on the part of these. Finally, 29 quality indicators were defined in the pharmaceutical care to the HIV+ patient distributed in structure, processes and results and the plan of improvement for the attention and his level of priority considered. DISCUSSION: This document gives response to the increasing demand for homogenizing the clinical practice and establishing common criteria of quality that result a benefit for the sanitary system and, in consequence, for the professionals and the patients.


Objetivo: Identificar y promover mejoras en la calidad de la atención sanitaria que reciben los pacientes VIH y SIDA en las Unidades Clínicas de los hospitales en nuestro país, incluyéndose y reforzando la perspectiva de Atención Farmacéutica (AF). Metodología: Para llevar a cabo el proyecto, durante el periodo Enero-Junio de 2012 se definieron las siguientes fases de trabajo. Primero, se realizó una revisión bibliográfica y lectura critica relacionada con la patología VIH-SIDA y criterios de calidad. A continuación, se llevó a cabo una fase de investigación cualitativa presencial con los expertos participantes. La primera se llevó a cabo mediante dos técnicas: el grupo nominal y una variante de grupos de discusión. La aplicación de las técnicas estuvo apoyada por un soporte informático que permitió la codificación y valoración jerarquizada de las propuestas mediante un sistema automatizado de votaciones. La última fase del proyecto consistió en una reunión presencial, donde se perfilaron los objetivos de la primera reunión y se puso en común todo el trabajo que los subgrupos de trabajo habían elaborado para consensuar los contenidos. De la primera selección de ideas, el equipo de investigación trabajó y priorizó aquellos elementos que describen y dan respuesta a los objetivos planteados. Concretamente, la correcta definición de los indicadores de calidad y de seguridad en el ámbito de la farmacia hospitalaria, elaborándose una ficha que describía cada aspecto a tener en cuenta para la posterior medición del indicador. Por último, se elaboró un plan de actuaciones para mejorar la práctica clínica, sintetizada según su nivel de prioridad. Resultados: A través de la metodología del proyecto, los expertos identificaron los criterios de calidad en el procedimiento de AF al paciente. Las principales barreras definidas fueron: presión asistencial, Sistemas de gestión de personal, Seguridad y desconocimiento de la farmacoterapia, falta de cultura de calidad y dificultades de acceso a la información. Entre los principales riesgos clínicos identificados destacaron: errores en las pautas con los cambios de tratamientos, falta de información de toda la medicación del paciente, falta de recursos asistenciales y de tiempo adecuado para realizar los procesos, falta de comunicación entre profesionales, desconocimiento de interacciones o eventos adversos Los principales resultados que se extrajeron del análisis de situación fueron que la línea prioritaria de actuación debía pasar por un enlace entre pacientes, especialistas y atención primaria. Igualmente se debería potenciar la gestión clínica de las unidades de VIH, el acceso a la información por todos los profesionales que realizan seguimiento farmacoterapeutico a estos pacientes y la mayor implicación por parte de estos. Por ultimo, se definieron 29 indicadores de calidad en la AF al paciente VIH distribuidos en estructura, procesos y resultados y el plan de mejora para la atención al paciente VIH y su nivel de prioridad considerado. Discusión: Con este documento se da respuesta a la creciente demanda por homogeneizar la labor asistencial y establecer criterios de calidad comunes que redunden un beneficio para el sistema sanitario y, en consecuencia, para los profesionales y los pacientes.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , Assistência Farmacêutica/normas , Serviço de Farmácia Hospitalar/normas , Indicadores de Qualidade em Assistência à Saúde , Barreiras de Comunicação , Acessibilidade aos Serviços de Saúde , Humanos , Relações Interprofissionais , Erros de Medicação/prevenção & controle , Programas Nacionais de Saúde/organização & administração , Avaliação de Processos e Resultados em Cuidados de Saúde/métodos , Avaliação de Processos e Resultados em Cuidados de Saúde/organização & administração , Assistência Centrada no Paciente/organização & administração , Serviço de Farmácia Hospitalar/organização & administração , Guias de Prática Clínica como Assunto , Pesquisa Qualitativa , Melhoria de Qualidade , Qualidade da Assistência à Saúde , Espanha
18.
Mol Psychiatry ; 18(5): 557-67, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-22801410

RESUMO

Perturbation of Disrupted-In-Schizophrenia-1 (DISC1) and D-serine/NMDA receptor hypofunction have both been implicated in the pathophysiology of schizophrenia and other psychiatric disorders. In the present study, we demonstrate that these two pathways intersect with behavioral consequences. DISC1 binds to and stabilizes serine racemase (SR), the enzyme that generates D-serine, an endogenous co-agonist of the NMDA receptor. Mutant DISC1 fails to bind to SR, facilitating ubiquitination and degradation of SR and a decrease in D-serine production. To elucidate DISC1-SR interactions in vivo, we generated a mouse model of selective and inducible expression of mutant DISC1 in astrocytes, the main source of D-serine in the brain. Expression of mutant DISC1 downregulates endogenous DISC1 and decreases protein but not mRNA levels of SR, resulting in diminished production of D-serine. In contrast, mutant DISC1 does not alter levels of ALDH1L1, connexins, GLT-1 or binding partners of DISC1 and SR, LIS1 or PICK1. Adult male and female mice with lifelong expression of mutant DISC1 exhibit behavioral abnormalities consistent with hypofunction of NMDA neurotransmission. Specifically, mutant mice display greater responses to an NMDA antagonist, MK-801, in open field and pre-pulse inhibition of the acoustic startle tests and are significantly more sensitive to the ameliorative effects of D-serine. These findings support a model wherein mutant DISC1 leads to SR degradation via dominant negative effects, resulting in D-serine deficiency that diminishes NMDA neurotransmission thus linking DISC1 and NMDA pathophysiological mechanisms in mental illness.


Assuntos
Proteínas do Tecido Nervoso/deficiência , Racemases e Epimerases/metabolismo , Esquizofrenia/genética , Esquizofrenia/patologia , Estimulação Acústica/efeitos adversos , Anfetamina/uso terapêutico , Análise de Variância , Animais , Astrócitos/efeitos dos fármacos , Astrócitos/metabolismo , Encéfalo/efeitos dos fármacos , Encéfalo/metabolismo , Linhagem Celular Transformada , Cicloeximida/farmacologia , Inibidores de Cisteína Proteinase/farmacologia , Modelos Animais de Doenças , Maleato de Dizocilpina/uso terapêutico , Dopaminérgicos/uso terapêutico , Relação Dose-Resposta a Droga , Comportamento Exploratório/fisiologia , Feminino , Proteína Glial Fibrilar Ácida/genética , Proteína Glial Fibrilar Ácida/metabolismo , Humanos , Inibição Psicológica , Leupeptinas , Masculino , Aprendizagem em Labirinto , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Mutação/genética , Fármacos Neuroprotetores/uso terapêutico , Ligação Proteica/efeitos dos fármacos , Reflexo de Sobressalto/genética , Esquizofrenia/tratamento farmacológico , Esquizofrenia/fisiopatologia , Serina/farmacologia , Transfecção
19.
Aliment Pharmacol Ther ; 35(5): 552-61, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22243034

RESUMO

BACKGROUND: Functional dyspepsia (FD) is a common disease without an established optimal treatment. AIM: To determine (i) the effect of acupuncture in relieving FD symptoms and improving life quality; (ii) the effect difference between acupoint and non-acupoint; and (iii) the effect difference among different acupoints. METHODS: A total of 712 eligible patients were included and randomly assigned to six groups (Group A: specific acupoints of the stomach meridian; Group B: non-specific acupoints of the stomach meridian; Group C: specific acupoints of alarm and transport points; Group D: specific acupoints of the gallbladder meridian; Group E: sham acupuncture of non-acupoints; and Group F: itopride). A treatment period of 4 weeks (continuous five sessions per week), and a follow-up period of 12 weeks were arranged. The outcomes were the (i) patients' response, (ii) symptoms improvement measured using the Symptom Index of Dyspepsia and (iii) quality-of-life improvement based on Nepean Dyspepsia Index. RESULTS: All groups had an improvement in dyspepsia symptoms and the QoL at the end of treatment, and the improvement was sustained for 4 weeks and 12 weeks. The overall response rate was significantly higher in acupuncture group A (70.69%), and lower in sham acupuncture group (34.75%), compared with itopride and other acupuncture groups. Similarly, the difference in symptoms and QoL improvement was significant between group A and the other acupuncture groups. CONCLUSIONS: Acupuncture is effective in the treatment of functional dyspepsia, and is superior to non-acupoint puncture. The benefit of acupuncture relies on acupoint specificity.


Assuntos
Pontos de Acupuntura , Terapia por Acupuntura/métodos , Dispepsia/terapia , Meridianos , Adulto , Dispepsia/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Índice de Gravidade de Doença , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
20.
Nutr Hosp ; 26(5): 1168-74, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-22072369

RESUMO

At the present time, the abuse of all class of sport nutritional supplements (NS) has extended the people who go regularly to gymnasiums. Between these substances there are the Protein Powder Supplements (PPS). The purpose of this study is to examine the consumption of PPS in 415 individuals from Seville fitness centers. All individuals were evaluated with anthropometric measurements and completed a questionnaire previously reviewed, evaluating the validity of the content, application, structure and presentation. 28% of the individuals were using or used PPS. Of the total, 42.7% of male individuals compared to 3.2% of the females. The use of PPS was higher than what has been reported in previous studies about supplement use in fitness center, 28% vs 10-14% aprox. The SPP use is associated with sex, age, and time of sport practiced. More than a 25% of the total individuals that attend a gym use PPS. The total individuals that attend a gym and use PPS far exceed the RDA of protein for general population and/or athletes, being able to cause problems of health.


Assuntos
Proteínas Alimentares/administração & dosagem , Suplementos Nutricionais/estatística & dados numéricos , Academias de Ginástica/estatística & dados numéricos , Antropometria , Estatura/fisiologia , Peso Corporal/fisiologia , Dieta , Feminino , Humanos , Modelos Logísticos , Masculino , Política Nutricional , Razão de Chances , Educação Física e Treinamento , Fatores Sexuais , Espanha/epidemiologia , Esportes/fisiologia , Inquéritos e Questionários
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