Asociación entre los niveles de ácido fólico con biomarcadores de riesgo cardiovascular en atletas de alto rendimiento / Association beetwen folic acid levels with cardiovascular risk biomarkers in high performance athletes

INTRODUCCIÓN: La deficiencia de ácido fólico y de vitamina B12 disminuye el rendimiento físico. Los atletas de alto rendimiento podrían tener una ingesta insuficiente de vitaminas del grupo B si se alimentan con dietas monótonas o de bajo consumo energético. Se ha demostrado que niveles bajos de homocisteína (Hcy) en sangre están normalmente asociados con la vitamina B12 y fólico, y con un menor riesgo cardiovascular, mostrándose el entrenamiento relacionado intenso con la hiperhomocisteinemia (HHcy) (> 12 mg / mL). OBJETIVO: Valorar el estado nutricional en B12 y fólico, y la situación cardiovascular en una muestra de deportistas de élite y estudiar el efecto de una suplementación en la población, donde el riesgo cardiovascular está presente. METODOLOGÍA: El estudio se ha llevado a cabo con 14 jugadores profesionales de balonmano > 18años, llevando un seguimiento durante dos meses de entrenamiento intermitente intenso y suplementado con 200 mg/d de ácido fólico y 2,5μg/d de vitamina B12. Tanto al inicio como a los dos meses y a los cuatro meses se valoró la ingesta de ácido fólico y vitamina B12 (mediante recordatorio de 72h y el software Nutriber®), y se determinaron los niveles de B12, fólico y Hcy mediante enzimoinmunoensayo(AU)

CONCLUSIÓN /DISCUSIÓN: Tanto la ingesta de vitamina B12 como su nivel plasmático fueron adecuados. La ingesta de fólico estaba de acuerdo con las RDIs en humanos sanos, pero por debajo de la ingesta diaria recomendada para deportistas (300μg/d) en el 14,3% de los sujetos al comienzo del estudio; ninguno se mostró deficiente después de la suplementación. Otros autores recomiendan un consumo más alto de ácido fólico para entrenamiento intermitente intenso (400- 500 mg/d), y teniendo en cuenta estas recomendaciones, nuestros resultados muestran un 50-85,5%, respectivamente, de deportistas con una ingesta deficiente de ácido fólico. Aun así, los niveles de ácido fólico en plasma se encuentran dentro de los niveles de referencia (ref. 4,2-19,9 ng/ml), aunque se encuentra una asociación negativa significativa entre los niveles plasmáticos de fólico y Hcy (p <0,05). ¿Cuál es la ingesta real recomendada de fólico y vitamina B12 en deportistas con entrenamiento intermitente intenso? Los atletas de élite deben ser controlados mediante un exhaustivo asesoramiento y seguimiento nutricional y clínico. Es necesario el ajuste de las recomendaciones de vitamina B12 y ácido fólico para optimizar el rendimiento deportivo y prevenir problemas cardiovasculares comunes asociados(AU)

INTRODUCTION: The deficiency of folic acid and vitamin B12 reduced physical performance. High performance athletes may have an insufficient intake of vitamins of group B if they are fedmonotonous diets with low energy consumption. It has been shown that low levels of homocysteine (Hcy) levels are usually associated with vitamin B12 and folic acid, and reduced cardiovascular risk, showing the intense training associated with hyperhomocysteinemia (HHcy) (> 12 mg / mL). OBJECTIVE: To assess the nutritional status of B12 and folate, and cardiovascular status in a sample of elite athletes and to study the effect of supplementation in the population where cardiovascular risk is present. METHODS: The study was conducted with 14 professional handball players > 18 years, followed for two months of intense intermittent training and supplemented with 200 mg / d of folic acid and 2.5μg /d of vitamin B12. At baseline and at two months and four months we evaluated the intake of folic acid and vitamin B12 (72h-recall and Nutriber ® software), and determined the levels of B12, folate and Hcy by enzyme immunoassay(AU)

CONCLUSION / DISCUSSION: Both the intake of vitamin B12 and its plasma level was adequate. Folate intake was according to the RDIs in healthy humans, but below the recommended daily intake for athletes (300μg / d) in 14.3% of subjects at baseline, none were poor after the supplementation. Other authors recommend a higher intake of folic acid to intense intermittent training (400 - 500 mg /d), and taking into account these recommendations, our results showed a 50-85.5%, respectively, Athletes with an inadequate intake of folic acid. Still, folic acid levels in plasma are within the reference levels (ref. 4.2 to 19.9 ng / ml), although there is a significant negative association between plasma levels of folate and Hcy (p <0.05). What is the recommended intake of folic real and vitamin B12 in intense intermittent training athletes? Elite athletes should be monitored by a comprehensive nutritional counseling and clinical monitoring. Adjustment is needed on the recommendations of vitamin B12 and folic acid to optimize athletic performance and prevent cardiovascular problems commonly associated(AU)

El farmacéutico en la administración de la comunidad autónoma de Andalucía / The pharmacist in the administration of the autonomous community of Andalusia

Objetivo: En primer lugar determinar las condiciones de acceso al Cuerpo de Farmacéuticos adscrito a la Administración Sanitaria de la Junta de Andalucía y en segundo lugar, conocer las distintas modalidades, cómo se han organizado los distintos cuerpos y cómo se estructuran en sus diferentes subgrupos. Además se analiza y define su régimen laboral. En tercer lugar, determinar la estructura orgánica y funciones de los distintos Cuerpos a los que tiene acceso el farmacéutico en la Administración de la Comunidad Autónoma Andaluza. Metodología: Revisión de la normativa, vigente y derogada, que regula los cuerpos y el sistema de acceso para Farmacéutico en la Comunidad Autónoma Andaluza. Conclusión: La figura del farmacéutico como agente sanitario en la legislación autonómica andaluza, se encuentra regulada en distintas normas que exigen una interpretación de acuerdo a los criterios de la Ley 6/185 de Ordenación de la Función Pública de la Junta de Andalucía. Las distintas modalidades de ejercicio profesional, ya sea como agente sanitario de la autoridad autonómica o como profesional especializado se definen en distintos estatutos orgánicos necesarios para definir claramente sus funciones y responsabilidades(AU)

Objetive: First to determine the conditions of access to the Pharmacists' Body assigned to the Sanitary Administration of the Meeting of Andalusia and secondly, to know the different modalities, how the different bodies have been organized and how they are structured in his different subgroups. In addition his labor regime is analyzed and defines. Thirdly, to determine the organic structure and functions of the different Bodies to which the pharmacist has access in the Administration of the Autonomous Andalusian Community. Methodology: Review of the regulation, in force and repealed, that regulates the bodies and the system of access for Pharmacist in the Autonomous Andalusian Community. Conclusion / discussion: The figure of the pharmacist like sanitary agent in the autonomous Andalusian legislation, is regulated in different procedure that demand an interpretation of agreement to the criteria of the Law 6/185 of Arrangement of the Public Function of the Meeting of Andalusia. The different modalities of professional exercise, already be like a sanitary agent of the autonomous authority or as specialized professional they are defined in different organic necessary by laws to define clearly his functions and responsibilities(AU)

Sediment and pollutant load modelling using an integrated urban drainage modelling toolbox: an application of City Drain.

Numerical and computational modelling of flow and pollutant dynamics in urban drainage systems is becoming more and more integral to planning and design. The main aim of integrated flow and pollutant models is to quantify the efficiency of different measures at reducing the amount of pollutants discharged into receiving water bodies and minimise the consequent negative water quality impact. The open source toolbox CITY DRAIN developed in the Matlab/Simulink environment, which was designed for integrated modelling of urban drainage systems, is used in this work. The goal in this study was to implement and test computational routines for representing sediment and pollutant loads in order to evaluate catchment surface pollution. Tested models estimate the accumulation, erosion and transport of pollutants--aggregately--on urban surfaces and in sewers. The toolbox now includes mathematical formulations for accumulation of pollutants during dry weather period and their wash-off during rainfall events. The experimental data acquired in a previous research project carried out by the Environmental Engineering Research Centre (CIIA) at the Universidad de los Andes in Bogotá (Colombia) was used for the calibration of the models. Different numerical approaches were tested for their ability to calibrate to the sediment transport conditions. Initial results indicate, when there is more than one peak during the rainfall event duration, wash-off processes probably can be better represented using a model based on the flow instead of the rainfall intensity. Additionally, it was observed that using more detailed models (compared with an instantaneous approach) for representing pollutant accumulation do not necessarily lead to better results.

Prenatal diagnosis of right aortic arch: associated findings, pregnancy outcome, and clinical significance of vascular rings.

OBJECTIVES: To analyze the characteristics and clinical implications of right aortic arch (RAA) detected in fetal life. METHODS: Retrospective study of all cases of RAA diagnosed prenatally in high-risk patients who underwent fetal echocardiography between 2000 and 2007. RESULTS: There were 48 RAA; 18 had vascular ring (Group 1), including 15 RAA with aberrant left subclavian artery and 3 double aortic arch, and 30 had not vascular ring (Group 2), all RAA with mirror-image branching. The prenatal diagnosis was confirmed in 94%. In Group 1 most fetuses had normal heart (89%), and none had 22q11 deletion. There were 16 live births and all infants but one are asymptomatic (mean follow-up of 31 months). In Group 2 almost all fetuses had congenital heart defects (CHDs) (97%), and five were chromosomally abnormal (17%), including four 22q11 deleted. The 1-year survival rate was 69%, which was significantly higher in Group 1 (89% vs 57%, p < 0.05). CONCLUSIONS: RAA can be accurately diagnosed by fetal echocardiography. The outlook for these patients largely depends on the presence of associated defects, mainly CHDs, and their severity. If isolated, aortic arch anomalies are asymptomatic vascular variants in most cases. This information is important to assist parental counseling in pregnancy.

Embarazo heterotópico espontáneo presentado como un abdomen agudo / Spontaneous heterotopic pregnancy presenting as an acute abdomen

Los embarazos heterotópicos son inusuales y su incidencia aumenta cuando se utilizan agentes inductores de la ovulación. El diagnóstico temprano de los mismos es difícil y en la mayoría de los casos se llega a producir un hemoperitoneo. Ante situaciones de dolor abdominal y gestación intrauterina se debe pensar en esta posibilidad. El embarazo ectópico será tratado quirúrgicamente dejando progresar el intrauterino. Los resultados son excelentes, consiguiéndose en un alto porcentaje de casos la evolución normal de la gestación intrauterina (AU)

Identification of two susceptibility loci for vascular fragility in the Brown Norway rat.

A trait of vascular fragility, characterized by the formation of abrupt defects within the elastic laminae of the abdominal aorta, has been identified in Brown Norway (BN) rats. These lesions are greatly exacerbated in F(1) rats from a BN x New Zealand genetically hypertensive (GH) intercross, implying that the genetic background provided by the GH rat influences lesion severity. The F(2) progeny of the BN x GH intercross were used to identify susceptibility loci for the lesions as well as exacerbating loci. Two major quantitative trait loci (QTLs) for number of internal elastic lamina lesions were identified on rat chromosomes 5 and 10, with the maximum "log of the odds ratio" (LOD) scores at D5Rat119 (LOD 5.0) and at D10Mit2 (LOD 4.5), respectively, together contributing 33.5% to the genetic variance. Further analysis revealed that the chromosome 10 locus exhibits a dominant mode of inheritance, with BN alleles being associated with increased lesion number (P < 0.0002) compared with GH homozygotes. This locus was in epistasis to a modifier locus on rat chromosome 2 at D2Mit14 (LOD score 2.12). A second major locus was identified on chromosome 5, exhibiting a semidominant mode of inheritance, again with the BN allele being significantly associated with increased lesion number (P < 0.0001). Furthermore, a locus influencing lesion severity was identified on chromosome 3 wherein GH alleles associated with increased severity. This is the first study to identify susceptibility loci for vascular elastic tissue fragility.

Basilar artery thrombosis in a child heterozygous for factor V Leiden mutation.

Activated protein C resistance, usually because of factor V Leiden mutation, is considered to be the most common hereditary prothrombotic condition. A 9-year-old male with a basilar artery stroke and activated protein C resistance is described. The patient, found to be heterozygous for factor V Leiden mutation, is one of several recent reports that suggest that activated protein C resistance is an important risk factor for spontaneous arterial thrombosis in infancy and childhood.

Early postsurgical bacterial contamination of the airways: a study on 28 open-heart patients.

One pre- and two postoperative cultures of tracheo-bronchial secretions were obtained from 28 cardiac patients, subjected to open-heart surgery. Four patients received preoperative antibiotics, and all but one received postoperative prophylactic antibiotics. Preoperatively, only one patient had potential pathogens; after surgery (mean intubation time 4.2 h), four patients (14.3%) had organisms; and after 19 h of intubation, 28% of the patients had potential pathogens in their tracheo-bronchial secretions. Only three of the seven organisms recovered from the last sample were clearly sensitive to the antibiotics given prophylactically; and two of these organisms were Group A beta-haemolytic streptococci. The early presence of organisms in the airways after intubation, the high incidence of colonization, and the ineffectiveness of prophylactic antibiotics in preventing this contamination are pointed out. The factors that may possibly influence colonization of airways among these patients are commented on.