Physiological, biochemical, anthropometric, and biomechanical influences on exercise economy in humans.

Interindividual variation in running and cycling exercise economy (EE) remains unexplained although studied for more than a century. This study is the first to comprehensively evaluate the importance of biochemical, structural, physiological, anthropometric, and biomechanical influences on running and cycling EE within a single study. In 22 healthy males (VO2 max range 45.5-72.1 mL·min-1 ·kg-1 ), no factor related to skeletal muscle structure (% slow-twitch fiber content, number of capillaries per fiber), mitochondrial properties (volume density, oxidative capacity, or mitochondrial efficiency), or protein content (UCP3 and MFN2 expression) explained variation in cycling and running EE among subjects. In contrast, biomechanical variables related to vertical displacement correlated well with running EE, but were not significant when taking body weight into account. Thus, running EE and body weight were correlated (R2 =.94; P<.001), but was lower for cycling EE (R2 =.23; P<.023). To separate biomechanical determinants of running EE, we contrasted individual running and cycling EE considering that during cycle ergometer exercise, the biomechanical influence on EE would be small because of the fixed movement pattern. Differences in cycling and running exercise protocols, for example, related to biomechanics, play however only a secondary role in determining EE. There was no evidence for an impact of structural or functional skeletal muscle variables on EE. Body weight was the main determinant of EE explaining 94% of variance in running EE, although more than 50% of the variability of cycling EE remains unexplained.

ACE inhibition modifies exercise-induced pro-angiogenic and mitochondrial gene transcript expression.

Skeletal muscle responds to endurance exercise with an improvement of biochemical pathways that support substrate supply and oxygen-dependent metabolism. This is reflected by enhanced expression of associated factors after exercise and is specifically modulated by tissue perfusion and oxygenation. We hypothesized that transcript expression of pro-angiogenic factors (VEGF, tenascin-C, Angpt1, Angpt1R) and oxygen metabolism (COX4I1, COX4I2, HIF-1α) in human muscle after an endurance stimulus depends on vasoconstriction, and would be modulated through angiotensin-converting enzyme inhibition by intake of lisinopril. Fourteen non-specifically trained, male Caucasians subjects, carried out a single bout of standardized one-legged bicycle exercise. Seven of the participants consumed lisinopril in the 3 days before exercise. Biopsies were collected pre- and 3 h post-exercise from the m. vastus lateralis. COX4I1 (P = 0.03), COX4I2 (P = 0.04) mRNA and HIF-1α (P = 0.05) mRNA and protein levels (P = 0.01) showed an exercise-induced increase in the group not consuming the ACE inhibitor. Conversely, there was a specific exercise-induced increase in VEGF transcript (P = 0.04) and protein levels (P = 0.03) and a trend for increased tenascin-c transcript levels (P = 0.09) for subjects consuming lisinopril. The observations indicate that exercise-induced expression of transcripts involved in angiogenesis and mitochondrial energy metabolism are to some extent regulated via a hypoxia-related ACE-dependent mechanism.

Absceso retroperitoneal secundario a espondilodiscitis tuberculosa simulando una hernia inguinal incarcerada.

Tuberculosis is the commonest cause of spinal infection worldwide (9-46%). Tuberculosis spondylodiscitis causes multifocal thoracic and lumbar spinal disease, and big paraspinal and psoas abscesses. It is more frequent in people under 40 who had previous tuberculosis infection and from countries where the illness is endemic. Clinic is non-specific and sub-acute. We report the clinical case of a 29-year-old patient who suffered from pericardic tuberculosis in her childhood and who presents a bilateral retroperitoneal abscess due to tuberculosis spondylodiscitis. Her clinical debut began with left inguinal pain and an irreducible mass at this level that simulated an incarcerated inguinal hernia, which is why surgery was indicated. Due to discrepancies between intraoperative findings and the initial diagnosis, the diagnosis and treatment strategy were changed. The purpose of this case report is to emphasize the challenge that the diagnosis of this pathology represents, due to low incidence in our environment and poor clinical features, which results in late diagnosis and late management.

Regional regulation of focal adhesion kinase after concentric and eccentric loading is related to remodelling of human skeletal muscle.

AIMS: We assessed focal adhesion kinase (FAK) response to concentric (CON) vs eccentric (ECC) resistance training (RT) at two vastus lateralis (VL) sites, and the relationships between FAK, muscle protein synthesis (MPS) and morphological remodelling. METHODS: Six young males trained both legs unilaterally 3 times/week for 8 weeks; one leg performed CON RT, the contralateral performed ECC RT. Muscle biopsies were collected after training from VL mid-belly (MID) and distal (distal) sites at 0, 4, 8 weeks. Focal adhesion kinase content and activation were evaluated by immunoblotting. MPS was assessed by deuterium oxide tracer; morphological adaptations were evaluated by ultrasound and DXA. RESULTS: pY397-FAK 8 weeks levels were ~4-fold greater after ECC at the distal site compared to CON (P < .05); pY397FAK to total FAK ratio was greater in ECC vs CON at 4 (~2.2-fold, P < .05) and 8 weeks (~9-fold, P < .001) at the distal site. Meta-vinculin was found transiently increased at 4 weeks at the distal site only after ECC RT. ECC presented greater fascicle length (Lf) increases (10.5% vs 4%), whereas CON showed greater in pennation angle (PA) changes (12.3% vs 2.1%). MPS did not differ between exercise types or muscle sites at all time points. distal pY397-FAK and pY397-FAK/FAK values correlated to changes in Lf at 8 weeks (r = .76, P < .01 and r = .66, P < .05 respectively). CONCLUSION: Focal adhesion kinase phosphorylation was greater at 8 weeks after ECC RT and was muscle region-specific. FAK activity correlated to contraction-dependent architectural remodelling, suggesting a potential role of FAK in orienting muscle structural changes in response to distinct mechanical stimuli.

Statistical analysis of the parameters of a neuro-genetic algorithm.

Interest in hybrid methods that combine artificial neural networks and evolutionary algorithms has grown in the last few years, due to their robustness and ability to design networks by setting initial weight values, by searching the architecture and the learning rule and parameters. This paper presents an exhaustive analysis of the G-Prop method, and the different parameters the method requires (population size, selection rate, initial weight range, number of training epochs, etc.) are determined. The paper also the discusses the influence of the application of genetic operators on the precision (classification ability or error) and network size in classification problems. The significance and relative importance of the parameters with respect to the results obtained, as well as suitable values for each, were obtained using the ANOVA (analysis of the variance). Experiments show the significance of parameters concerning the neural network and learning in the hybrid methods. The parameters found using this method were used to compare the G-Prop method both to itself with other parameter settings, and to other published methods.

[Retinal autofluorescence imaging in patients with pseudoxanthoma elasticum]. / Imágenes funduscópicas con autofluorescencia en pacientes con pseudoxantoma elástico.

PURPOSE: To evaluate the autofluorescence findings in patients diagnosed with pseudoxanthoma elasticum. MATERIAL AND METHODS: A prospective study was conducted on 18 eyes of 9 patients who had ocular pathology andfollowed up in the pseudoxanthoma elasticum (PSX) unit of our hospital. We evaluated the best corrected visual acuity (BCVA), colour and autofluorescence photography (AF), and fluorescein angiography (FA) in patients with choroidal neovascularitation. RESULTS: Of the 9 patients, 7 were women and 2 were men. The mean age was 40 +/- 14 years. The BCVA ranged from 1 to 0.01 (Mean 0.65 +/- 0.4). All patients showed PSX injuries. Angioid streaks (AS) 18 (100%), peau d'orange 16 (87.5%) and pigmented fibrotic plates 5 (31,5%). We observed different hypoautofluorescence patterns (RPE atrophy), of which 2 of them were AS patterns (irregular lines with hyperautofluorescence speckled in its interior and edges, or bands with lobulated lesions inside and hyperautofluorescence at the edges), and finally widespread areas of hypoautofluorescence, larger than observed by ophthalmoscope. CONCLUSIONS: Autofluorescence in patients with PSX is an easy method to evaluate the initial level of ophthalmoscopic involvement and its subsequent progression. The extensive changes in the retinal pigment epithelium (RPE) suggests the important role of this in the physiopathology of the disease.

Imágenes funduscópicas con autofluorescencia en pacientes con pseudoxantoma elástico / Retinal autofluorescence imaging in patients with pseudoxanthoma elasticum

PropósitoEvaluar las lesiones funduscópicas con autofluorescencia en pacientes diagnosticados de pseudoxantoma elástico (PSX).Material y métodoSe realizó un estudio prospectivo de 9 pacientes (18 ojos), en seguimiento por la unidad de PSX de nuestro hospital, que presentaban dolencia ocular. Evaluamos mejor agudeza visual corregida (MAVC), fotografía en color y con autofluorescencia (FA), así como angiografía fluoresceínica (AFG) en los casos que presentaban neovascularización coroidea (NVC).ResultadosDe los 9 pacientes, 7 eran mujeres y 2 hombres. Edad media de 40,5 +/- 14, MAVC desde la 1 a 0,01 (media=0,65 +/- 0,4). Todos los pacientes (18 ojos) presentaban lesiones del PSX: estrías angioides (EA) en 18 (100%), fondo en «piel de naranja» en 16 (87,5%) y placas fibrogliales pigmentadas en 5 ojos (31,5%). Observamos diferentes patrones de hipoautofluorescencias (atrofia de epitelio pigmentario), dos que se corresponderían a EA (líneas anfractuosas con moteado hiperautofluorescente en su seno y bordes, o bien bandas con lesiones lobuladas en su seno e hiperautofluorescencia en sus bordes) y por último grandes placas hipoautofluorescentes, de mayor tamaño que las observadas funduscópicamente.ConclusionesLa autofluorescencia en los pacientes con PSX es un método fácil para valorar el grado de afectación funduscópica inicial y su posterior evolución. La gran afectación del epitelio pigmentario retiniano (EPR), que hemos observado, nos sugiere el importante papel que juega este, en la fisiopatología de esta enfermedad(AU)

PurposeTo evaluate the autofluorescence findings in patients diagnosed with pseudoxanthoma elasticum.Material and methodsA prospective study was conducted on 18 eyes of 9 patients who had ocular pathology andfollowed up in the pseudoxanthoma elasticum (PSX) unit of our hospital. We evaluated the best corrected visual acuity (BCVA), colour and autofluorescence photography (AF), and fluorescein angiography (FA) in patients with choroidal neovascularitation.ResultsOf the 9 patients, 7 were women and 2 were men. The mean age was 40 +/- 14 years. The BCVA ranged from 1 to 0.01 (Mean 0.65 +/- 0.4).All patients showed PSX injuries. Angioid streaks (AS) 18 (100%), peau d‘orange 16 (87.5%) and pigmented fibrotic plates 5 (31,5%). We observed different hypoautofluorescence patterns (RPE atrophy), of which 2 of them were AS patterns (irregular lines with hyperautofluorescence speckled in its interior and edges, or bands with lobulated lesions inside and hyperautofluorescence at the edges), and finally widespread areas of hypoautofluorescence, larger than observed by ophthalmoscope.ConclusionsAutofluorescence in patients with PSX is an easy method to evaluate the initial level of ophthalmoscopic involvement and its subsequent progression. The extensive changes in the retinal pigment epithelium (RPE) suggests the important role of this in the physiopathology of the disease(AU)

[Anonymous serological screening for HIV infection in umbilical cord blood by the pooled-batch system]. / Cribado serológico anónimo de infección VIH en sangre de cordón umbilical por el sistema de lotes.

OBJECTIVE: The aim of this study was to estimate the sero-prevalence of HIV infections in pregnant women of the health area of Zamora, Spain by unlinked anonymous screening and to estimate the percentage of non-diagnosed cases by non-systematic screening. PATIENTS AND METHODS: Umbilical cord blood samples of 2,695 newborns at "Virgen de la Concha" hospital of Zamora collected between January 1994 and December 1996 were stored with a code number and with no personal identification. HIV antibody testing in the serum from the umbilical cord blood was performed with an enzyme-immunoassay using pooled sera and verified with Western blot. All children born to HIV-infected women during the same period were registered. RESULTS: Four of 2,695 samples were seropositive. HIV prevalence was 0.15% (CI 95%, 0.04-0.37). During the same period only 3 children born to HIV infected women were recognized. We estimate that at least 25% of seropositive women were undetected. CONCLUSIONS: We conclude that routine HIV screening should be offered to all pregnant women.

Las Porinas como adyuvante de una vacuna inactivada contra Newcastle en pollos de engorde / Porinas as an adyuvant of inactivated Newcastle vaccine in Broilers

Tres grupos de pollo de engorde, de 25 aves cada uno, fueron vacunados por via de aerosol, utilizando virus inactivado de Newcastle (NC), y como adyuvante diferentes concentraciones de porinas (20 ¦Ìg, 50 ¦Ìg, 125 ¦Ìg) y un cuarto grupo vacunado con virus vivo (cepa B1 por via nasal), a los 12 y 28 días de edad. El virus de NC (cepa La Sota) fue concentrado 10 veces con PEG (Polietilenglicol), con un título final de 1:2.056. Veinte sueros de cada uno de los grupos fueron tomados para evaluar títulos de anticuerpos para NC, utilizando la prueba de Inhibición de la Hemoaglutinación (IH) e IgA por Inmunodifusión radial, al día 1, 12, 28 y 42 de edad. Durante el estudio, los pollos fueron sometidos a restricción alimenticia para controlar la Ascitis (2.640 m.s.n.m.). Al día 42 de edad, dos aves murieron por ascitis del grupo 4 (virus vivo) y una del grupo 1 (20 ¦Ìg de porina), por edema pulmonar. El promedio geom¨¦trico de los títulos de anticuerpos para NC al día 42, en los grupos 1, 2, 3, fue de 2 y de 5.7 para el grupo de virus vivo (Log 2). Para las IgA fue de 180 mg/dl, 135 mg/dl, 120 mg/dl y 176 mg/dl, respectivamente. Al día 42 de edad, tres pollos de cada grupo fueron desafiados con una cepa patógena de NC, observandose resistencia a la descarga, especialmente en el grupo vacunado con virus vivo, con base en las aves utilizadas como control positivo, las cuales murieron a las 72 horas post descarga. Los exómenes macro y microscópicos de las bolsas de Fabricio y el timo, no revelaron ningún cambio, en las aves de los cuatro grupos al días 42 de edad. El resultado zootécnico en los cuatro grupos, mostró muy buenos resultados en cuanto a conversión y eficiencia. Se recomienda realizar otros ensayos utilizando una dosis fija de porina, con un grupo mayor de aves, con el fin de estandarizar el empleo de porinas como adyuvante de virus inactivados y establecer los niveles protectivos de IgA, frente al desafío con virus de NC­.

Manejo del tumor anexial / Adnexal mass management

Estudio retrospectivo que evalúa la aplicación de una asociación de factores de riesgo para malignidad ovárica denominada "predicción de malignidad" en una población que acude al Servicio de Ginecología del HNGAI-IPSS (94-95) con el diagnóstico de tumor anexial, en quienes se efectúa laparotomía cuando la predicción de malignidad es negativa o positiva, respectivamente. El uso de la laparoscopía es cada vez más frecuente ante la preocupación de si este abordaje asegura un buen manejo oncológico del tumor ovárico. Sin embargo, al igual que otras series publicadas, nuestra incidencia de malignidad ovárica es 0,8 por ciento. Palabras clave: Laparoscopía, tumor anexial, malignidad, factores de riesgo, ovario.

Manejo de tumor ovárico: laparotomía vs. laparoscopía / Handling of ovarian tumor: laparotomia vs laparoscopy

Estudio retrospectivo sobre cirugía del tumor ovárico en 166 pacientes que acudieron al Servicio de Ginecología del Hospital Guillermo Almenara Irigoyen - IPSS (1994-1996). En quienes se efectuó laparoptomía o laparoscopía según la Prdicción de Malignidad de tumor ovárico : edad, examen pélvico, ultrasonido y CA-125. En el grupo premenopáusico (edad reproductiva) se encontró cáncer ováricio en 1/108 (0.9 por ciento) laparoscopías y en 17/23 (74 por cientro) laparotomías, y en el grupo posmenopáusico el cáncer primario de ovario fue en 0/12 (0 por ciento) laparoscipías y en 15/23 (65 por ciento) laparotomías, constituyendo la laparoscopía una buena alternativa quirúrgica para el manejo de tumor ovárico, recomendando el uso del CA-125 en las posmenopáusicas

Lesiones benignas de la mama / Breast benign disease

Estudio retrospectivo de 1238 de biopsias de mama efectuada en el Hospital Guillermo Almenara I. Durante el período 1990-1995. Las lesiones benignas constituyen el 74,21 por ciento (950). Los fibroadenomas tienen una distribución en la primera mitad de la vida reproductiva y las alteraciones fibroquísticas predominan en la perimenopausia. La sensibilidad de la ecografía mamaria (87,5 por ciento) y del BAAF (85,8 por ciento) indican que estos métodos son adecuados para el diagnóstico de las lesiones benignas. Se recomienda el uso de la clasificación de Page modificada para el registro histopatológico. Palabras clave: Mama, enfermedades benignas, alteraciones fibroquísticas.