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1.
Int. j. morphol ; 42(3): 761-765, jun. 2024. tab
Artículo en Inglés | LILACS | ID: biblio-1564619

RESUMEN

SUMMARY: To take advantage of altitude, "intermittent hypoxia" methods have been developed that involve shorter exposures to hypoxia. In general, systemic hypoxia can be produced in two ways: (1) by lowering barometric pressure (BP, hypobaric hypoxia) or (2) by reducing the amount of oxygen in inspired air (FiO2) through oxygen filtration or nitrogen dilution (normobaric hypoxia). The objective of this analysis was to observe changes in body composition and aerobic performance after 8 weeks of intermittent hypoxia exposure at rest. A total of 20 male volunteers between the ages of 18-26 participated in the study. Participants were randomly divided into 2 groups (Control Group and Intermittent Hypoxia Group). The Intermittent Hypoxia Group completed the process by being exposed to intermittent hypoxia for 8 weeks. Each intermittent hypoxia session was planned as 3 days a week and for 1 hour. After 8 weeks of experimental process, statistically significant differences were found for lean mass, android lean mass, gynoid lean mass, the relative skeletal muscle mass index, peak lactate, 1mmol lactate threshold, 4mmol lactate threshold, and MaxVo2 variables (p<0,05). After 8 weeks of intermittent hypoxia exposure, an increase in maximal oxygen consumption capacity was observed. The increase in lean mass, especially in the gynoid and android regions, can be explained by the increase in fat burning activities due to oxygen utilization capacity. Almost every study reviewed in the literature used different intermittent hypoxia exposure protocols and different simulated altitudes. The method discussed in this study may be beneficial on the body composition and oxygen utilization capacity of sedentary individuals.


Para aprovechar la altitud, se han desarrollado métodos de «hipoxia intermitente» que implican exposiciones más cortas a la hipoxia. En general, la hipoxia sistémica se puede producir de dos maneras: (1) reduciendo la presión barométrica (PA, hipoxia hipobárica) o (2) reduciendo la cantidad de oxígeno en el aire inspirado (FiO2) mediante filtración de oxígeno o dilución de nitrógeno (hipoxia normobárica). El objetivo de este análisis fue observar cambios en la composición corporal y el rendimiento aeróbico después de 8 semanas de exposición intermitente a hipoxia en reposo. Participaron en el estudio un total de 20 voluntarios varones de entre 18 y 26 años. Los participantes se dividieron aleatoriamente en 2 grupos (grupo control y grupo hipoxia intermitente). El grupo de hipoxia intermitente completó el proceso al estar expuesto a hipoxia intermitente durante 8 semanas. Cada sesión de hipoxia intermitente se planificó 3 días a la semana y durante 1 hora. Después de 8 semanas de proceso experimental, se encontraron diferencias estadísticamente significativas para la masa magra, la masa magra androide, la masa magra ginoide, el índice de masa muscular esquelético relativo, el pico de lactato, el umbral de lactato de 1 mmol, el umbral de lactato de 4 mmol y las variables MaxVo2 (p< 0,05). Después de 8 semanas de exposición intermitente a hipoxia, se observó un aumento en la capacidad máxima de consumo de oxígeno. El aumento de la masa magra, especialmente en las regiones ginoidea y androide, puede explicarse por el aumento de las actividades de quema de grasa debido a la capacidad de utilización de oxígeno. Casi todos los estudios revisados en la literatura utilizaron diferentes protocolos de exposición intermitente a la hipoxia y diferentes altitudes simuladas. El método analizado en este estudio puede ser beneficioso para la composición corporal y la capacidad de utilización de oxígeno de personas sedentarias.


Asunto(s)
Humanos , Masculino , Adolescente , Adulto , Adulto Joven , Composición Corporal , Rendimiento Atlético , Hipoxia , Consumo de Oxígeno
2.
J Phys Act Health ; 20(5): 411-417, 2023 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-37024104

RESUMEN

BACKGROUND: Little is known about the effect of disability type on perceived physical activity (PA) constraints. Investigating the leisure-time PA constraint differences across disability groups would increase the possibility of PA participation, and reverse the physical inactivity trend for disabled populations. OBJECTIVE: The purpose was to examine perceived PA constraint differences between individuals with 3 different disability types, which are visual, hearing, and physical disabilities. METHODS: The study sample comprised 305 individuals with a visual disability, 203 individuals with a physical disability, and 144 individuals with hearing loss. Leisure Time PA Constraints Scale-Disabled Individuals Form, consisting of 32 items and 8 subscales, was used as for data collection. Data were analyzed with a 3 × 2 two-way multivariate analysis of variance. RESULTS: Findings indicated a significant main effect of the disability group (Pillai V = 0.025; F16,639 = 10.132, P < .001, η2 = .112), gender (Pillai V = 0.250; F8,639 = 2.025, P < .05, η2 = .025), and interaction between the disability group and gender (Pillai V = 0.069; F161,280 = 2.847, P < .001, η2 = .034). The follow-up analyses of variance indicated significant differences in facility quality, social environment, family, willpower, time, and ability perception scores between disability groups, P < .05. CONCLUSIONS: People with different disabilities have different perceived leisure-time PA barriers with respect to environmental, social, and psychological factors; generally, disabled females perceived more barriers to leisure-time PA. Policies and intervention protocols for disabled individuals should directly address the disability-specific need of individuals to increase leisure-time PA participation.


Asunto(s)
Personas con Discapacidad , Ejercicio Físico , Femenino , Humanos , Ejercicio Físico/psicología , Actividades Recreativas/psicología , Actividad Motora , Medio Social
3.
Int J Dev Disabil ; 68(6): 850-857, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36568624

RESUMEN

The aim of this study was to explore the relationships between autism severity, motor performance, independence in daily living skills and quality of life in adolescents with autism spectrum disorder (ASD). The study included 31 participants, aged 13-18 years. Evaluations were made with the Gilliam Autistic Disorders Rating Scale-2 (GARS-2), Bruininks-Oseretsky Test of Motor Proficiency-2 Short Form (BOT-2-SF), Functional Independence Measure (WeeFIM II), and Pediatric Quality of Life Inventory (PedsQL). Motor performance of the participants was determined as below average according to the norms of BOT-2 SF, and were negatively correlated with GARS-2 at a moderate level (r = -0.61, p < 0.001), and a moderate negative correlation was determined between GARS-2 and WeeFIM II (r = -0.65, p < 0.001) and PedsQL (r = -0.61, p < 0.001). Independence in daily living skills (DLS) and autism severity were found to be significant predictors of PedsQL (R2 = 0.463, p < 0.05). Motor impairment still appears to be a missing piece of the puzzle for this age group. Promoting motor skill acquisition and independence could be a key factor in preventing the deterioration of physical health and improving quality of life in adolescents with ASD.

4.
Life (Basel) ; 12(5)2022 Apr 25.
Artículo en Inglés | MEDLINE | ID: mdl-35629299

RESUMEN

Cardiovascular disease (CVD) remains underestimated in familial Mediterranean fever-associated AA amyloidosis (FMF-AA). We aimed to compare early markers of endothelial dysfunction and atherosclerosis in FMF-AA with a homozygous M694V mutation (Group 1 = 76 patients) in the Mediterranean fever (MEFV) gene and in patients with other genotypes (Group 2 = 93 patients). Measures of increased risk for future CVD events and endothelial dysfunction, including flow-mediated dilatation (FMD), pentraxin-3 (PTX3), and carotid intima-media thickness (cIMT), and fibroblast growth factor 23 (FGF23) as a marker of atherosclerotic vascular disease were compared between groups. The frequency of clinical FMF manifestations did not differ between the two groups apart from arthritis (76.3% in Group 1 and 59.1% in Group 2, p < 0.05). FMD was significantly lower in Group 1 when compared with Group 2 (MD [95% CI]: −0.6 [(−0.89)−(−0.31)]). cIMT, FGF23, and PTX3 levels were higher in Group 1 (cIMT MD [95% CI]: 0.12 [0.08−0.16]; FGF23 MD [95% CI]: 12.8 [5.9−19.6]; PTX3 MD [95% CI]: 13.3 [8.9−17.5]). In patients with FMF-AA, M694V homozygosity is associated with lower FMD values and higher cIMT, FGF23, and PTX3 levels, suggesting increased CVD risk profiles. These data suggest that a genotype−phenotype association exists in terms of endothelial dysfunction and atherosclerosis in patients with FMF-AA.

5.
Exp Clin Endocrinol Diabetes ; 125(4): 256-261, 2017 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-28201828

RESUMEN

Background: Intensive insulin treatment is bothersome in obese patients with type 2 diabetes mellitus. High insulin dosages further increase weight gain and the risk of hypoglycemia. Glucagon like peptide-1 receptor agonists decrease the insulin need, cause weight loss and reduce the risk of hypoglycemia. There is limited data about the effect of exenatide on obese diabetics under intensive insulin regimens. Methods: This retrospective case series report the clinical outcomes of 23 obese (13 morbidly obese) patients with uncontrolled type 2 diabetes mellitus (Age=59±10.44 years, body mass index 41.1±6.8 kg/m2, HbA1c 9.9±1.5%), under high dose (94.1±39.6 unit) intensive insulin. Exenatide twice daily was added for a mean follow-up period of 11.22±7.01 (3-30) months. Intensive insulin regimens were continued in 7 patients while the others were switched to basal insulin during the follow-up. Results: During the follow-up, mean HbA1c levels of the patients significantly improved (p=0.019), along with the significant decrease in body mass index and the total insulin need (p<0.001 for both). Baseline insulin dosages were significantly higher in the intensive regimen group (p=0.013) while other demographical and clinical characteristics were similar. No significant difference was present between the groups regarding the alterations of HbA1c, body mass index and the reduction in total insulin dosages. Conclusion: Add on exenatide appears to be a rational treatment modality in uncontrolled obese patients with type 2 diabetes mellitus despite intensive insulin regimens. Further prospective randomized studies with longer follow-up periods are recommended.


Asunto(s)
Diabetes Mellitus Tipo 2/tratamiento farmacológico , Hipoglucemiantes/administración & dosificación , Insulina/administración & dosificación , Obesidad Mórbida/tratamiento farmacológico , Péptidos/administración & dosificación , Ponzoñas/administración & dosificación , Anciano , Glucemia/efectos de los fármacos , Glucemia/metabolismo , Diabetes Mellitus Tipo 2/complicaciones , Relación Dosis-Respuesta a Droga , Quimioterapia Combinada , Exenatida , Femenino , Estudios de Seguimiento , Hemoglobina Glucada/análisis , Hemoglobina Glucada/metabolismo , Humanos , Masculino , Persona de Mediana Edad , Obesidad Mórbida/complicaciones , Estudios Retrospectivos , Resultado del Tratamiento
6.
Disabil Rehabil ; 35(1): 47-56, 2013 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-22624856

RESUMEN

OBJECTIVE: To investigate the effectiveness of the video prompting procedure on teaching aquatic play skills and to determine the effects of aquatic exercise training on the motor performance of children with autism. DESIGN: A multiple probe design across behaviours was used and replicated across subjects for the instructional part of this study. Pretest-posttest design was applied for the exercise training part of this study. METHODS: Three children with autism were taught three aquatic play skills in a one-to-one training format. Aquatic play skills intervention and aquatic exercise training were performed separately throughout 12 weeks at three sessions per week, each lasting 1 h. The video prompting procedure was utilized for the instruction part of this study. RESULTS: Video prompting was effective in teaching aquatic play skills to children with autism. In addition, aquatic exercise training increased the total motor performance scores of all the participants after 12 weeks. According to the social validity results, the families gave positive feedback about the learned skills and movement capabilities of their children. CONCLUSION: Aquatic play skills and swimming pools are favoured for children with autism. This attractive intervention is recommended as a means to extend knowledge of leisure skills and motor development of children with autism.


Asunto(s)
Trastorno Autístico/terapia , Ejercicio Físico/psicología , Destreza Motora , Juego e Implementos de Juego/psicología , Grabación de Cinta de Video/métodos , Niño , Educación Especial , Humanos , Aprendizaje , Actividades Recreativas , Masculino , Conducta Social , Encuestas y Cuestionarios , Análisis y Desempeño de Tareas
7.
Dev Neurorehabil ; 14(6): 389-93, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-22136123

RESUMEN

OBJECTIVE: The purpose of this study was to compare the effects of inclusion education programmes with special education programmes on physical fitness levels of children with mental challenges. METHODS: Participants were 69 elementary school students with mental challenges. Thirty-four children with a mean age of 12.3 ± 2.4 were included in an inclusion physical education programme with non-disabled peers. In addition, 35 children with a mean age of 12.1 ± 1.8 participated in a special class for children with mental challenges. Balance tests, grip strength and Brockport Physical Fitness Test (BPFT) were used to evaluate the physical fitness levels of children. RESULTS: Results indicated that physical fitness parameters; 20 metre shuttle run, push-up, trunk lift, vertical jump and balance test scores were significantly lower in children in the special class (p < 0.05). There were no significant differences in BMI, calf skinfold thickness, grip strength in dominant hand, sit and reach test and modified Apley test (p > 0.05). CONCLUSION: The physical fitness level was better in children with mental challenges who were participating in an inclusion programme with non-disabled peers. Therefore, it is recommended for children with mental challenges to be part of an inclusion programme with their non-disabled peers.


Asunto(s)
Educación de las Personas con Discapacidad Intelectual , Ejercicio Físico , Discapacidad Intelectual/rehabilitación , Educación y Entrenamiento Físico , Aptitud Física , Adolescente , Niño , Femenino , Humanos , Masculino
8.
Asian Pac J Cancer Prev ; 11(3): 697-702, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-21039038

RESUMEN

BACKGROUND: Rapid hematological engraftment at autologous peripheral stem cell transplantation (APSCT) is a significant factor in reduction of early transplant-related complications and costs. For this reason, it is important to determine influences on hematological recovery. METHODS: This study was designed to evaluate factors affecting leukocyte and platelet engraftment times after high dose chemotherapy following APSCT. A total of 228 patients (131 males and 97 females) were enrolled. RESULTS: There were statistically significant differences between patients with CD34+ cell doses ≥ 2.5 x 106/kg (n=180) and < 2.5 x 106/kg (n=48), regarding leukocyte engraftment at 11 and 12 days, respectively (p<0.02), between G-CSF (n=167) and GM-CSF (n=61) posttransplant regarding median leukocyte engraftment times (p=0.005), and between with (n=75) or without (n=153) history of pretransplant radiotherapy for both leukocyte and platelet engraftment times (p<0.001). CONCLUSIONS: For leukocyte engraftment, a history of pretransplant radiotherapy, type of growth factor used and number of CD34+ cells infused, and for platelet engraftment, a history of pretransplant radiotherapy were found to be independent variables on multivariate analysis with the Cox regression method.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Supervivencia de Injerto/fisiología , Neoplasias Hematológicas/terapia , Trasplante de Células Madre de Sangre Periférica , Adolescente , Adulto , Anciano , Niño , Femenino , Movilización de Célula Madre Hematopoyética , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Factores de Tiempo , Trasplante Autólogo , Adulto Joven
10.
J Strength Cond Res ; 18(3): 480-5, 2004 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-15320653

RESUMEN

The purpose of this study was to describe certain morphological characteristics of women soccer players and to examine aspects of training and performance. Twenty-two anthropometric sites were used in measurements of somatotype and body composition; flexibility, agility, anaerobic power, leg muscle power, and dynamic pulmonary functions were used as performance variables. Measurements were made on 17 professional athletes and 17 age-matched sedentary women who acted as controls. The women soccer players showed less fat content and less lean body mass than did the sedentary women. The mean somatotype for the soccer players was 3.07-3.55-2.43 and for the nonathletes was 3.57-3.35-2.90. Anaerobic power, leg muscle power, and agility in the athletes were higher than in the nonathletes, whereas no differences were found in flexibility and pulmonary functions (p > 0.05). The women soccer players showed more significantly mesomorphic, less endomorphic, least ectomorphic components and higher performance level than did the sedentary women.


Asunto(s)
Tamaño Corporal/fisiología , Ejercicio Físico/fisiología , Fútbol/fisiología , Análisis y Desempeño de Tareas , Adolescente , Adulto , Composición Corporal/fisiología , Femenino , Humanos , Estilo de Vida , Músculo Esquelético/fisiología , Docilidad , Pruebas de Función Respiratoria , Somatotipos/fisiología
11.
J Clin Apher ; 18(3): 120-4, 2003.
Artículo en Inglés | MEDLINE | ID: mdl-14569602

RESUMEN

In the past, variable results were reported for single daily and two divided daily doses of granulocyte colony-stimulating factor (G-CSF) in stem cell collection where no study exists investigating the effect of body mass index (BMI) on mobilization. The numbers of CD34(+) cells collected were compared in 86 patients with solid or hematological malignancies receiving either single daily (14 mug/kg/day) G-CSF (filgrastim) as group I (n=36) or two divided doses of G-CSF daily (2 x 7 mug/kg/day) as group II (n = 50). Both groups were divided into subgroups according to their BMI as group a (BMI 25 kg/m(2)). Two groups were similar in terms of BMI, gender, and disease characteristics. All patients have received G-CSF as a single or two divided doses subcutaneously and aphereses have been done on the 5th day. No significant difference in numbers of CD34(+) cells between groups Ia and Ib, groups IIa and IIb, and groups Ia and IIa was found. On the other hand, the mean ratio and the number of CD34(+) cells in group Ib were significantly higher than those of group IIb (0.58 +/- 0.06% vs. 0.37 +/- 0.26%, P = 0.01 and 3.67 +/- 0.65 x 10(4)/kg/ml vs. 1.92 +/- 0.37 x 10(4)/kg/ml, P= 0.02). In conclusion, in patients with BMI >25 kg/m(2), once daily G-CSF compared to split dose administration induces a greater number of CD34(+) stem cell mobilization, which suggests the presence of a different pharmacokinetics in obese patients.


Asunto(s)
Factor Estimulante de Colonias de Granulocitos/metabolismo , Neoplasias Hematológicas/terapia , Movilización de Célula Madre Hematopoyética/métodos , Neoplasias/metabolismo , Obesidad/complicaciones , Adolescente , Adulto , Anciano , Antígenos CD34/biosíntesis , Eliminación de Componentes Sanguíneos/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad
12.
J Rehabil Med ; 35(1): 44-5, 2003 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-12610848

RESUMEN

OBJECTIVE: The effects of hydrotherapy on an 11-year-old girl with stage III Rett syndrome were investigated. METHODS: The Halliwick method was used to apply hydrotherapy in a swimming pool twice a week for 8 weeks. The girl's physical abilities were assessed 3 times: before and 5 minutes after a single hydrotherapy session and after 8 weeks of hydrotherapy. The tests included analysis of stereotypical movements, functional hand use, hand skills, gait and balance, hyperactive behaviour, communication and social interaction. RESULTS: Immediately after hydrotherapy, stereotypical movements decreased and this decrease continued during the following 8 weeks. The girl's feeding activities and hand skills increased markedly. After 8 weeks of hydrotherapy, her walking balance was improved, interaction with her environment increased and hyperactive behaviour and anxiety decreased. CONCLUSION: In conclusion, after the application of hydrotherapy, stereotypical hand movements had decreased and purposeful hand functions and feeding skills increased in this case. Whether hydrotherapy has a positive effect on the functional use of the hand in Rett syndrome should be investigated using more subjects.


Asunto(s)
Hidroterapia , Síndrome de Rett/terapia , Adolescente , Conducta Alimentaria/fisiología , Femenino , Mano/fisiopatología , Humanos , Equilibrio Postural/fisiología , Síndrome de Rett/fisiopatología , Resultado del Tratamiento , Caminata/fisiología
13.
Int Urol Nephrol ; 35(3): 345-50, 2003.
Artículo en Inglés | MEDLINE | ID: mdl-15160536

RESUMEN

DNA, protein oxidation and lipid peroxidation possess a major impact in carcinogenesis. Also, inflammatory and oxidative events have remarkable importance in bladder cancer. Thus, in this study total protein, protein carbonyl, nitrotyrosine, thiol residues, non-protein thiols, lipid peroxidation, and also, because of their relations to the above parameters, iron and iron binding levels have been investigated in patients with bladder cancer and in control group. Statistical evaluation of the results demonstrated significantly lower plasma protein levels in the patients with bladder cancer, as compared to the healthy control group. Serum iron levels in patients with invasive bladder cancer were found to be significantly lower when compared with non-invasive group. Protein carbonyl groups were remarkably higher in bladder cancer patients than in healthy controls. Patients with bladder cancer were demonstrated to have significantly lower levels of total thiol groups and protein-bound thiol groups as compared to healthy controls. Protein-bound thiol groups in patients with invasive bladder cancer revealed a more significant decline, than in non-invasive group.


Asunto(s)
Biomarcadores de Tumor/sangre , Carcinoma de Células Transicionales/diagnóstico , Oxidación-Reducción , Estrés Oxidativo/fisiología , Tirosina/análogos & derivados , Neoplasias de la Vejiga Urinaria/diagnóstico , Anciano , Análisis de Varianza , Proteínas Sanguíneas/metabolismo , Carcinoma de Células Transicionales/metabolismo , Estudios de Casos y Controles , Humanos , Hierro , Peroxidación de Lípido/fisiología , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Probabilidad , Pronóstico , Valores de Referencia , Medición de Riesgo , Sensibilidad y Especificidad , Compuestos de Sulfhidrilo/metabolismo , Tirosina/metabolismo , Neoplasias de la Vejiga Urinaria/metabolismo
14.
Clin Exp Pharmacol Physiol ; 29(4): 281-4, 2002 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-11985536

RESUMEN

1. Oxidative damage has been suggested to be a contributory factor in the development and complications of diabetes. Recently, alpha-lipoic acid (ALA) has gained considerable interest as an anti-oxidant. Various studies have indicated the anti- oxidant effects of ALA and its reduced form dihydrolipoic acid. Therefore, it appears that these compounds have important therapeutic potential in conditions where oxidative stress is involved. The aim of the present study was to investigate the effect of ALA supplementation on lipid peroxidation and anti-oxidant enzyme activities in various tissues in diabetic rats. 2. Male Wistar rats were divided into three groups. Diabetes was induced by streptozotocin (STZ) injection in the two groups of rats to be supplemented and not to be supplemented with ALA. Another group of rats, which received saline injection, formed the control group. After 5 weeks of diabetes, rats were killed. In order to assess the redox status of various organs in the diabetic and control rats, thiobarbituric acid-reactive substances (TBARS) and glutathione (GSH) levels, as well as superoxide dismutase (SOD), glutathione peroxidase (G-Px) and glutathione reductase (G-Red) activities were determined in the liver, pancreas and kidney. 3. In both diabetic groups, TBARS levels and SOD activity were increased in the liver and pancreas, G-Px and G-Red activities were increased in the kidney and GSH levels were decreased in all organs compared with controls. In the ALA- supplemented group, TBARS levels were decreased, GSH levels were increased in the liver and pancreas, SOD activity was decreased in the liver, G-Px activity remained unchanged in all tissues and G-Red activity was increased in the pancreas compared with the diabetic group that did not receive ALA supplementation. 4. In conclusion, ALA supplementation has disparate effects on the redox status of different organs. These data are not sufficient for confirmation the beneficial effects of ALA supplementation on the redox status of various organs in diabetic rats.


Asunto(s)
Antioxidantes/farmacología , Diabetes Mellitus Experimental/enzimología , Peroxidación de Lípido/efectos de los fármacos , Ácido Tióctico/farmacología , Animales , Antioxidantes/uso terapéutico , Diabetes Mellitus Experimental/tratamiento farmacológico , Diabetes Mellitus Experimental/metabolismo , Activación Enzimática/efectos de los fármacos , Activación Enzimática/fisiología , Glutatión Peroxidasa/metabolismo , Glutatión Reductasa/metabolismo , Peroxidación de Lípido/fisiología , Masculino , Ratas , Ratas Wistar , Superóxido Dismutasa/metabolismo , Ácido Tióctico/uso terapéutico , Regulación hacia Arriba/efectos de los fármacos , Regulación hacia Arriba/fisiología
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