Quercetin supplementation promotes recovery after exercise-induced muscle damage: a systematic review and meta-analysis of randomized controlled trials.

Quercetin (Q) is one of the most frequently consumed flavonoids in the human diet. The purpose of this systematic review and meta-analysis was to determine the effects of Q supplementation on muscle damage, muscle soreness and biochemical markers of inflammation, antioxidant capacity and oxidative stress after intense exercise. A literature search of SPORTDiscus, PubMed, Web of Science and Scopus was performed from inception to May 31, 2022. Forest plots were generated with fixed or random-effect models and standardized mean differences (SMD). Data extraction and quality assessment were performed independently by two authors. After application of the inclusion and exclusion criteria, 13 studies with a total of 249 sedentary to well-trained participants were included. For all studies there were some concerns about the risk of bias. All but one study used a supplementation dosage of 1000 mg/day. Q supplementation accelerated recovery of muscle function and significantly decreased muscle soreness 0/24 h after exercise (SMD: -1.33; p = 0.03), creatine kinase levels 24/48 h after exercise (SMD: -1.15; p = 0.02), and post-exercise oxidative stress (SMD: -0.92; p = 0.03). However, Q supplementation had no effect on IL-6 concentration. Q supplementation with a dose of 1000 mg/day for periods of more than seven days and a maximum of 12 weeks appears to be a safe and efficacious strategy to reduce muscle damage and muscle soreness, as well as to enhance recovery after intense exercise in sedentary to well-trained young men. Systematic review registration: PROSPERO CRD42021266801.

Estimating the heating of complex nanoparticle aggregates for magnetic hyperthermia.

Understanding and predicting the heat released by magnetic nanoparticles is central to magnetic hyperthermia treatment planning. In most cases, nanoparticles form aggregates when injected in living tissues, thereby altering their response to the applied alternating magnetic field and preventing the accurate prediction of the released heat. We performed a computational analysis to investigate the heat released by nanoparticle aggregates featuring different sizes and fractal geometry factors. By digitally mirroring aggregates seen in biological tissues, we found that the average heat released per particle stabilizes starting from moderately small aggregates, thereby facilitating making estimates for their larger counterparts. Additionally, we studied the heating performance of particle aggregates over a wide range of fractal parameters. We compared this result with the heat released by non-interacting nanoparticles to quantify the reduction of heating power after being instilled into tissues. This set of results can be used to estimate the expected heating in vivo based on the experimentally determined nanoparticle properties.

Effects of vitamin D supplementation on muscle function and recovery after exercise-induced muscle damage: A systematic review.

BACKGROUND: Vitamin D is essential for the optimal health of the skeletal system. However, this vitamin is also involved in other functions of the human body, such as muscle, immune and inflammatory ones. Some studies suggest that adequate levels of vitamin D support muscular function during exercise and accelerate recovery because they reduce specific pro-inflammatory cytokine levels, but those results have not always been observed. Therefore, this review aims to evaluate the effects of vitamin D supplementation on inflammation, oxidative stress and recovery after exercise. METHODS: This systematic review was conducted using the Preferred Reporting of Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A literature search of SPORTDiscuss, PubMed, Web of Science and Scopus was performed from inception through February 2022. The articles' methodological quality was assessed with the PEDro scale. RESULTS: After the application of the inclusion and exclusion criteria, 11 eligible articles were included. All the studies were considered of moderate methodological quality. Ten studies involved regular vitamin D supplementation for more than 7 days, and one study performed acute vitamin D supplementation 24 h before exercise. CONCLUSIONS: The existing evidence suggests that vitamin D supplementation for periods of more than 1 week with a minimum dose of 2000 IU/day appears to be an efficacious strategy for attenuating muscle damage and inflammation after exercise. The potential positive effects on muscle function, muscle pain and oxidative stress need to be confirmed with new investigations. Further research is also required to determine the adequate vitamin D dosage to obtain positive effects without adverse effects.

Heating of metallic biliary stents during magnetic hyperthermia of patients with pancreatic ductal adenocarcinoma: an in silico study.

OBJECTIVE: To investigate the eddy current heating that occurs in metallic biliary stents during magnetic hyperthermia treatments and to assess whether these implants should continue to be an exclusion criterion for potential patients. METHODS: Computer simulations were run on stent heating during the hyperthermia treatment of local pancreatic tumors (5-15 mT fields at 300 kHz for 30 min), considering factors such as wire diameter, type of stent alloy, and field orientation. Maxwell's equations were solved numerically in a bile duct model, including the secondary field produced by the stents. The heat exchange problem was solved through a modified version of the Pennes' bioheat equation assuming a temperature dependency of blood perfusion and metabolic heat. RESULTS: The choice of alloy has a large impact on the stent heating, preferring those having a lower electrical conductivity. Only for low field intensities (5 mT) and for some of the bile duct tissue layers the produced heating can be considered safe. The orientation of the applied field with respect to the stent wires can give rise to the onset of regions with different heating levels depending on the shape that the stent has finally adopted according to the body's posture. Bile helps to partially dissipate the heat that is generated in the lumen of the bile duct, but not at a sufficient rate. CONCLUSION: The safety of patients with pancreatic cancer wearing metallic biliary stents during magnetic hyperthermia treatments cannot be fully assured under the most common treatment parameters.

Effects of Beetroot Supplementation on Recovery After Exercise-Induced Muscle Damage: A Systematic Review.

CONTEXT: Beetroots have antioxidant and anti-inflammatory properties, which may help attenuate inflammation and oxidative stress, enhancing recovery from exercise-induced muscle damage (EIMD). OBJECTIVE: To evaluate the effects of beetroot supplementation on oxidative stress, inflammation, and recovery after EIMD. DATA SOURCES: SPORTDiscus, PubMed, Web of Science, and Scopus databases were searched, and hand-searching was performed by looking to relevant studies that were cited in other studies. STUDY SELECTION: For a study to be included in this review, the following inclusion criteria had to be met: (1) research conducted with human participants, (2) original articles in peer-reviewed publications, (3) original studies that had investigated beetroot supplementation intervention on muscle damage and recovery, (4) research conducted with 1 control/placebo group, and (5) articles published from inception to October 2020. STUDY DESIGN: Systematic review using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. LEVEL OF EVIDENCE: Level 3. DATA EXTRACTION: Two of the 4 authors independently extracted data and assessed the methodological quality of the articles with the PEDro scale. All discrepancies were resolved through a consensus meeting. RESULTS: A total of 9 studies were included in this review. The methodological quality of the included studies ranged from moderate to high. Most of the studies found a better recovery of functional variables and muscle soreness, but improvements in markers of muscle damage, inflammation, and oxidative stress were not reported. CONCLUSION: The existing evidence suggests that a short-term beetroot supplementation has the potential to accelerate recovery of functional measures and muscle soreness, but further research is needed to clarify if a longer supplementation period (with some days before exercise and some days after) could also promote recovery of markers of muscle damage, inflammation, and oxidative stress.

Cambios en la composición corporal y ángulo de fase durante la pretemporada en jugadores de fútbol profesional / Changes in body composition and phase angle during pre-season in professional soccer players

RESUMEN: El análisis y el control de la composición corporal son claves en el fútbol por su implicación en el rendimiento. El objetivo de este estudio fue identificar, en jugadores de futbol profesional, el ángulo de fase (PhA) de miembros inferiores con los posibles patrones de mejora del componente magro en los mismos medido por DEXA. Al mismo tiempo, se estudió mediante BIA la evolución de parámetros hídricos de los jugadores, sometidos a un entrenamiento intenso y a un control nutricional de su alimentación y suplementación. Se evaluaron a 18 jugadores (26,28 ± 5,1 años; 85,09 ± 9,16 kg; 185,5 ± 4,32 cm) de un equipo de la primera división de fútbol italiana. Se llevó a cabo el estudio durante cuatro semanas, entre el 11 de julio (pre-test) y el 11 de agosto de 2021 (post-test). La intervención se llevó a cabo en su totalidad en pretemporada, con un confinamiento en modalidad de aislamiento o burbuja total por prevención al contagio del COVID-19, dónde se monitorizaba en un alto porcentaje la vida del jugador, incluyendo factores como la alimentación, el entrenamiento y el descanso. La suplementación estuvo basada en antioxidantes, multivitamínicos, minerales y ácidos grasos poliinsaturados y dos productos en polvo (uno a base de creatina, glutamina y leucina, y otro, a base de aminoácidos esenciales). Los jugadores presentaron una mejora del PhA y del componente magro en los miembros inferiores, con una moderada correlación (r = 0,6). Con respecto al agua intracelular y extracelular, señalar que, a pesar de la alta intensidad del ejercicio durante cuatro semanas, éstas se han mantenido constantes sin presentar variaciones significativas durante el periodo de estudio, lo que indica que no se ha producido un proceso de deshidratación del jugador.

SUMMARY: The analysis and control of body composition is essential in soccer due to its implication in performance. The aim of this study was to identify, in professional soccer players, the phase angle (PhA) of the lower limbs with possible patterns of improvement of the lean component measured by DEXA. At the same time, the evolution of hydric parameters of the players, subjected to intense training and nutritional control of their diet and supplementation, was studied by means of BIA. Eighteen players (26.28 ± 5.1 years; 85.09 ± 9.16 kg; 185.5 ± 4.32 cm) from an Italian first division football team were evaluated. The study was conducted for four weeks, between 11th July (pre- test) and 11th August of 2021 (post-test). The intervention was carried out entirely in pre-season, with confinement in isolation or total bubble mode for prevention of COVID-19 infection, where a high percentage of the player's life was monitored, including factors such as diet, training and rest. Supplementation was based on antioxidants, multivitamins, minerals and polyunsaturated fatty acids and two powdered products (one based on creatine, glutamine and leucine, and the other one, on essential amino acids). The players showed an improvement in PhA and in the lean component in the lower limbs, with a moderate correlation (r = 0.6). With regard to intracellular and extracellular water, it should be noted that, despite the high intensity of exercise during four weeks, these have remained constant without significant variations during the study period, indicating that there has not been a process of dehydration of the player.

Regular, but not acute, green tea supplementation increases total antioxidant status and reduces exercise-induced oxidative stress: a systematic review.

This systematic review aims to investigate the effects of green tea supplementation on exercise-induced oxidative stress. Four electronic databases were searched from inception to December 2020: SPORTDiscuss, PubMed, Scopus, and Web of Science. The search strategy was established in the following manner: (green tea) (Title/Abstract) AND (exercise OR training) (Title/Abstract) AND (oxidative stress OR antioxidant OR oxidation) (Title). After the application of inclusion and exclusion criteria 11, randomized or non-randomized control trials were included, 6 with a parallel design and 5 with a crossover design. Study methodological quality was assessed with the PEDro scale, and all studies were considered of moderate quality. Overall, acute green tea ingestion does not appear to influence antioxidant status or reduce exercise-induced oxidative stress. In contrast, green tea supplementation before exercise, for periods of more than 1 week, in a dose range of 400 to 800 mg of catechins per day, appears to be efficacious to increase total antioxidant status and protect cells against exercise-induced oxidative stress. Future investigations should focus on beginning green tea supplementation more than 7 days before exercise and completing it 2 or 3 days after while monitoring the change of markers of oxidative stress up to 48-72 h after exercise.

In silico assessment of collateral eddy current heating in biocompatible implants subjected to magnetic hyperthermia treatments.

Purpose: Bearing partially or fully metallic passive implants represents an exclusion criterion for patients undergoing a magnetic hyperthermia procedure, but there are no specific studies backing this restrictive decision. This work assesses how the secondary magnetic field generated at the surface of two common types of prostheses affects the safety and efficiency of magnetic hyperthermia treatments of localized tumors. The paper also proposes the combination of a multi-criteria decision analysis and a graphical representation of calculated data as an initial screening during the preclinical risk assessment for each patient.Materials and methods: Heating of a hip joint and a dental implant during the treatment of prostate, colorectal and head and neck tumors have been assessed considering different external field conditions and exposure times. The Maxwell equations including the secondary field produced by metallic prostheses have been solved numerically in a discretized computable human model. The heat exchange problem has been solved through a modified version of the Pennes' bioheat equation assuming a temperature dependency of blood perfusion and metabolic heat, i.e. thermorregulation. The degree of risk has been assessed using a risk index with parameters coming from custom graphs plotting the specific absorption rate (SAR) vs temperature increase, and coefficients derived from a multi-criteria decision analysis performed following the MACBETH approach.Results: The comparison of two common biomaterials for passive implants - Ti6Al4V and CoCrMo - shows that both specific absorption rate (SAR) and local temperature increase are found to be higher for the hip prosthesis made by Ti6Al4V despite its lower electrical and thermal conductivity. By tracking the time evolution of temperature upon field application, it has been established that there is a 30 s delay between the time point for which the thermal equilibrium is reached at prostheses and tissues. Likewise, damage may appear in those tissues adjacent to the prostheses at initial stages of treatment, since recommended thermal thresholds are soon surpassed for higher field intensities. However, it has also been found that under some operational conditions the typical safety rule of staying below or attain a maximum temperature increase or SAR value is met.Conclusion: The current exclusion criterion for implant-bearing patients in magnetic hyperthermia should be revised, since it may be too restrictive for a range of the typical field conditions used. Systematic in silico treatment planning using the proposed methodology after a well-focused diagnostic procedure can aid the clinical staff to find the appropriate limits for a safe treatment window.

Reaching Deeper: Absolute In Vivo Thermal Reading of Liver by Combining Superbright Ag2S Nanothermometers and In Silico Simulations.

Luminescent nano-thermometry is a fast-developing technique with great potential for in vivo sensing, diagnosis, and therapy. Unfortunately, it presents serious limitations. The luminescence generated by nanothermometers, from which thermal readout is obtained, is strongly distorted by the attenuation induced by tissues. Such distortions lead to low signal levels and entangle absolute and reliable thermal monitoring of internal organs. Overcoming both limitations requires the use of high-brightness luminescent nanothermometers and adopting more complex approaches for temperature estimation. In this work, it is demonstrated how superbright Ag2S nanothermometers can provide in vivo, reliable, and absolute thermal reading of the liver during laser-induced hyperthermia. For that, a new procedure is designed in which thermal readout is obtained from the combination of in vivo transient thermometry measurements and in silico simulations. The synergy between in vivo and in silico measurements has made it possible to assess relevant numbers such as the efficiency of hyperthermia processes, the total heat energy deposited in the liver, and the relative contribution of Ag2S nanoparticles to liver heating. This work provides a new way for absolute thermal sensing of internal organs with potential application not only to hyperthermia processes but also to advanced diagnosis and therapy.

El laboratorio clínico en odontología / The clinical laboratory in dentistry

El laboratorio clínico es un área de soporte de la medicina y pertenece al grupo de los auxiliares de diagnóstico. Se pueden encontrar dentro de hospitales, clínicas o establecimientos externos; dependiendo del tamaño del laboratorio, son las áreas y pruebas que se pueden realizar. Analizan todos los componentes y productos del cuerpo humano (sangre, saliva, etc.), obteniendo más información sobre el estado de salud del paciente complementado con una historia clínica minuciosa y la exploración física completa, confi rman un diagnóstico o proporcionan información útil sobre el estado del paciente y la respuesta al tratamiento. En la práctica odontológica, de rutina se envían los estudios preoperatorios donde evaluamos un cuadro clínico conocido, identifi camos pacientes de alto riesgo en busca de alguna nueva enfermedad que pudiera modifi car o complicar la intervención quirúrgica. Es obligatorio que el odontólogo sepa la existencia de las pruebas y sus indicaciones, enviarlas cuando sean necesarias y no escatimar en estudios complementarios si así lo requiere el paciente. Y en caso de detectar una anomalía en los resultados, se debe referir al paciente a un especialista (AU)

The clinical laboratory is a support area for medicine and belongs to the group of auxiliaries for the diagnostic. They can be found inside hospitals, clinics or external sites, depending on the size of the laboratory, the areas and the tests that can be performed. Analyze all the components and products of the human body (blood, saliva, etc.), obtaining more information about the state of the patient's health, complementing with a detailed clinical history and the complete physical examination, confi rming a diagnosis or useful information about the state of the patient and the response to treatment. In routine dental practice, preoperative studies are sent where a known clinical condition is evaluated, identify high-risk patients and in search of a new disease that can modify or complicate the surgical intervention. It is mandatory that the dentist knows the existence of the tests and their indications when things are necessary and do not skimp on complementary studies if the patient so requires. And in case of detecting an anomaly in the results, the patient should be referred to a specialist (AU)

ECG parameters to predict left ventricular electrical delay.

AIMS: Left ventricular (LV) dyssynchrony lengthens the left ventricular electrical delay (LVED), measured from QRS onset to the first peak of the LV electrogram. We constructed an ECG model to predict LVED noninvasively. METHODS: Intrapatient LVED was measured during a baseline vs nonselective His bundle pacing (nHBP) protocol. This setup provided paired synchronic/non-synchronic LVEDs, allowing intrapatient comparisons. Crosscorrelation of leads II and V6 was accomplished and extracted features together with age and gender fed a linear mixed effects model to predict LVED. RESULTS: Hemodynamic increments were consistent with LVED advances under nHBP in a subset of 17 patients (dP/dtmax, baseline: 938.82 ± 241.95 mm Hg/s vs nHBP: 1034.94 ± 253.63 mm Hg/s, p = 6.24e-4). The inclusion of the area under V6 (AV 6) and the time shift of R-peaks obtained from the crosscorrelation signal (CorS) grouped by patient significantly improved LVED estimation with respect to the model based only on QRS duration, age and gender (p = 1.7e-5). CONCLUSIONS: Interlead ECG changes explained LVED, providing clues about the electrical impulse conduction within the left ventricle noninvasively.

Non-selective His bundle pacing with a biphasic waveform: enhancing septal resynchronization.

Aims: His bundle pacing has shown to prevent detrimental effects from right ventricular apical pacing (RVA) and proved to resynchronize many conduction disturbances cases. However, the extent of His bundle pacing resynchronization is limited. An optimized stimulation waveform could expand this limit when implemented in His bundle pacing sets. In this work, we temporarily implemented RVA and Non-selective His bundle pacing with a biphasic anodal-first waveform (AF-nHB) and compared their effects against sinus rhythm (SR). Methods and results: Fifteen patients referred for electrophysiologic study with conduction disturbances, cardiomyopathy and ejection fraction below 35% were enrolled for the study. The following acute parameters were measured: QRS duration, left ventricular activation (RLVT), time of isovolumic contraction (IVCT), ejection fraction (EF), and dP/dtmax. QRS duration and RLVT decreased markedly under AF-nHB (SR: 169 ± 34 ms vs. nHB: 116 ± 31 ms, P < 0.0005) while RVA significantly increased QRS duration (SR: 169 ms vs. RVA: 198 ms, P < 0.05) and did not change RLVT (P = NS). Consistently, IVCT moderately decreased under AF-nHB (SR: 238 ms vs. RVA: 184 ms, P < 0.05 vs. SR) and dP/dtmax showed a 93.35 [mmHg] average increase under AF-nHB against SR. Also, T-wave inversions were observed during AF-nHB immediately after SR and RVA pacing suggesting the occurrence of cardiac memory. Conclusions: AF-nHB corrected bundle branch blocks in patients with severe conduction disturbances, even in those with dilated cardiomiopathy, outstanding from RVA. Also, the occurrence of cardiac memory during AF-nHB turned up as an observational finding of this study.

Real-time tracking of delayed-onset cellular apoptosis induced by intracellular magnetic hyperthermia.

AIM: To assess cell death pathways in response to magnetic hyperthermia. MATERIALS & METHODS: Human melanoma cells were loaded with citric acid-coated iron-oxide nanoparticles, and subjected to a time-varying magnetic field. Pathways were monitored in vitro in suspensions and in situ in monolayers using fluorophores to report on early-stage apoptosis and late-stage apoptosis and/or necrosis. RESULTS: Delayed-onset effects were observed, with a rate and extent proportional to the thermal-load-per-cell. At moderate loads, membranal internal-to-external lipid exchange preceded rupture and death by a few hours (the timeline varying cell-to-cell), without any measurable change in the local environment temperature. CONCLUSION: Our observations support the proposition that intracellular heating may be a viable, controllable and nonaggressive in vivo treatment for human pathological conditions.