THREE-YEAR OUTCOMES IN A RANDOMIZED SINGLE-BLIND CONTROLLED TRIAL OF INTRAVITREAL RANIBIZUMAB AND ORAL SUPPLEMENTATION WITH DOCOSAHEXAENOIC ACID AND ANTIOXIDANTS FOR DIABETIC MACULAR EDEMA.

PURPOSE: To report 3-year results of a randomized single-blind controlled trial of intravitreal ranibizumab combined with oral docosahexaenoic acid (DHA) supplementation versus ranibizumab alone in patients with diabetic macular edema. METHODS: There were 26 patients (31 eyes) in the DHA group and 29 (38 eyes) in the control group. Ranibizumab (0.5 mg) was administered monthly for the first 4 months followed by a pro re nata (PRN) regimen. In the experimental group, patients received oral DHA supplementation (1,050 mg/day) (Brudyretina 1.5 g). RESULTS: At 36 months, mean decrease of central subfield macular thickness was higher in the DHA-supplementation group than in controls (275 ± 50 µm vs. 310 ± 97 µm) with significant differences at Months 25, 30, 33, and 34. Between-group differences in best-corrected visual acuity were not found, but the percentages of ETRDS gains >5 and >10 letters were higher in the DHA-supplementation group. Differences serum HbA1c, plasma total antioxidant capacity values, erythrocyte DHA content, and serum IL-6 levels were all significant in favor of the DHA-supplementation group. CONCLUSION: The addition of a high-rich DHA dietary supplement to intravitreal ranibizumab was effective to achieve better sustained improvement of central subfield macular thickness outcomes after 3 years of follow-up as compared with intravitreal ranibizumab alone.

COMBINED INTRAVITREAL RANIBIZUMAB AND ORAL SUPPLEMENTATION WITH DOCOSAHEXAENOIC ACID AND ANTIOXIDANTS FOR DIABETIC MACULAR EDEMA: Two-Year Randomized Single-Blind Controlled Trial Results.

PURPOSE: To assess the 2-year effectiveness of intravitreal ranibizumab combined with a dietary supplement rich in docosahexaenoic acid (DHA) plus antioxidants in 62 patients with diabetic macular edema. METHODS: In a randomized single-blind controlled study, 33 subjects (42 eyes) received intravitreal ranibizumab alone and 29 (34 eyes) combined with DHA (1,050 mg/day). Monthly ranibizumab (0.5 mg) was given for the first 4 months followed by on as-needed treatment. RESULTS: At 24 months, the difference between groups in the decrease of central subfield macular thickness was significant in favor of the DHA supplementation group (95% confidence interval of the difference 7.20-97.656; P = 0.024), although improvement in best-corrected visual acuity measured in the Early Treatment Diabetic Retinopathy Study letters did not reach statistical significance (95% confidence interval 5.4-11.2, P < 0.66). At 24 months, gains of >5 and >10 letters were significantly higher in the DHA supplementation group as compared with controls when the worse and better seeing eyes were considered but other differences at 12 months and 24 months were not found. CONCLUSION: Intravitreal ranibizumab combined with DHA supplementation reduced central subfield macular thickness after 2 years of follow-up as compared with ranibizumab alone in patients with diabetic macular edema. This anatomical improvement was accompanied by a trend for an amelioration of vision.

Effects of high-resistance circuit training in an elderly population.

The aim of this study was to determine the efficacy of a program of high-resistance circuit (HRC) training, and to compare the effects of HRC to traditional heavy strength (TS) training on strength, muscle size, body composition and measures of cardiovascular fitness in a healthy elderly population. Thirty-seven healthy men and women (61.6±5.3years) were randomly assigned to HRC (n=16), TS (n=14), or a control group (CG, n=7). Training consisted of weight lifting twice a week for 12weeks. Before and after the training, isokinetic peak torque in the upper and lower body, and body composition (dual X-ray absorptiometry) were determined. In addition, cardiovascular parameters were evaluated during an incremental treadmill test. Both HRC and TS groups showed significant increases in isokinetic strength (p<0.001), and the increase was significantly greater in the experimental groups than in CG (p<0.03). There were significant increases in lean mass (HRC, p<0.001; TS, p=0.025) and bone mineral density (HRC, p=0.025; TS, p=0.018) in the experimental groups. Only HRC showed a significant decrease in fat mass (p=0.011); this decrease was significantly greater in HRC than in CG (p=0.039). There were significant improvements in walking economy in the HRC group (p<0.049), although there were no statistical differences between groups. There were no changes in any variables in CG. Hence, HRC training was as effective as TS for improving isokinetic strength, bone mineral density and lean mass. Only HRC training elicited adaptations in the cardiovascular system and a decrease in fat mass.

Estudio comparativo postesfuerzo de lactacidemia, PH y electrolitos según el lugar de muestreo / Comparative study I postexercise lactacidemia, PH and electrolytes depending of the site of sampling

Existen múltiples estudios en los que se demuestra la existencia de cifras de lactacidemia distintas dependiendo del componente sanguíneo analizado (sangre completa o plasma), del vaso sanguíneo utilizado para realizar la extracción (arteria, capilar o vena), del lugar de toma de la muestra (miembro ejercitado en reposo), del tiempo que transcurre hasta el análisis de la muestra, de la metodología empleada para la extracción y del analizador utilizado. Dada la importancia del lactato como parámetro biológico clave implicado en los mecanismos de la fatiga muscular, así como en la determinación de las zonas de transición metabólica aeróbica-anaeróbica durante la actividad física y la trascendencia de éstas en la programación del entrenamiento, nos parece necesario investigar la posible influencia de los distintos factores mencionados sobre los valores de lactacidemia. El mayor conocimiento de todas estas variables aportará nuevos datos para mejorar la metodología en lo referente, entre otros aspectos, al lugar óptimo de extracción, la técnica utilizada y el análisis de las muestras sanguíneas, lo que nos permitirá obtener conclusiones fisiológicas más fiables. En nuestro estudio hemos apreciado diferencias significativas entre los valores de lactato aportados por las micromuestras sanguíneas de oreja y pulpejo del dedo y los procedentes del sudor, siendo estos últimos mucho mayores; no resultando significativas, por el contrario, las observadas entre las micromuestras del dedo y la oreja. También nos parece interesante estudiar otros parámetros en estas muestras biológicas y observar sus posibles relaciones. Concretamente, pretendemos analizar la relación que algunos autores han observado entre las cifras de lactato, los gases sanguíneos y algunos iones implicados en el anión gap1-3. En este sentido, la variable Presión Parcial de Oxígeno (PpO2) parece tener una escasa influencia en las cifras de lactato obtenidas delas micromuestras del dedo y oreja, y tampoco se ha observado una buena correlación lineal entre las lactacidemias sudor de doy sudor-oreja. En cuanto a los electrolitos, hemos obtenido diferencias significativas en cuanto al sodio, calcio, cloruro y bicarbonato, siendo en todos ellos mayores las cifras halladas en la muestra del dedo (AU)

There exist multiple studies in which is demonstrated the existence of different numbers of lactacidemia depending of the blood component analyzed (complete blood or plasma), of the blood glass used to realize the extraction (artery, capillary or vein), of the place of capture of the sample (exercised member or in rest), of the time that passes up to the analysis of the sample, of the methodology used for the extraction and of the used analyzer. Given the importance of the lactate as biological key parameter involved in the mechanisms of the muscular fatigue, as well as in the determination of the zones of metabolic transition aerobic-anaerobic during the physical activity and the trascendency of these in the programming of the training, us seems to be necessary to investigate the possible influence of the different factors mentioned on the values of lactacidemia. The greater knowledge of all these variables will contribute new information to improve the methodology in the relating thing, among other aspects, to the ideal place of extraction, the used technology and the analysis of the blood samples, which will allow us to extract trust worthier physiological conclusions. In our study we have estimated significant differences between the values of lactate contributed by the fingertip and ear lobe blood microsamples and the proceeding ones from the sweat, being very much bigger the above mentioned; not being significant, on the contrary, the observed ones between the micro samples of the finger and the ear. Also it seems us interesting to analyze other parameters in these biologycal samples and to study its possible relations Concretely, we try to analyze the relationship that some authors have observed between the numbers of lactate, blood gases and some ions implied in the an ión gap1-3. In these sense, the parameter Partial Pressure of Oxygen (PpO2) seems to have a scanty influence in the numbers of lactate obtained of the finger and ear, and a good linear correlation has not been observed between the lactacidemias sweat-finger and sweat-ear either. As for the electrolytes, we have obtained significant differences as for the sodium, calcium, chloride, and bicarbonate, being higher in all of them the numbers found in the sample of the finger (AU)

Valoración multimétodo de la composición corporal en karatecas / Multimethod valuation of the body composition in karatecas

La imporatncia que la constitución física, tanto la composición corporal como el somatotipo, presenta con relación al rendimiento deportivo ha sido ampliamente estudiada en múltiples disciplinas atléticas dado que existen patrones de referencia construidos a partir de los individuos que configuran la élite de cada deporte. En el caso del kárate, la escasez de trabajos con deportistas de nuestro país nos animó a realizar un estudio de un grupo de karatecas utilizando técnicas de Cineantropometría Bioimpedanciometría y Densiometría Pletismográfica. Hemos estudiado un amplio grupo de karatecas de sexo masculino, de edades comprendidas entre los 20 y los 30 años, con un nivel mínimo de cinturón verde, que entrena un mínimo de 4 horas semanales y que participa en competiciones regionales, nacionales y/o internacionales. Nuestro interés se centró en calcular su Prototipo Morfológico y su Composición Corporal, así como en estudiar el grado de similitud existente entre los diversos métodos que evalúan dicha composición corporal. Nuestro grupo tiene un somatotipo medio (3.4-5.7-1.6), que puede ser definido como Endo-Mesomórfico. Además, no encontramos la suficiente homogeneidad biotipológica en nuestra muestra ya que el Indice de Dispersión del Somatotipo es de 3.05. En cuanto a la composición corporal, el porcentaje de grasa calculado por los diferentes métodos, superó claramente el 10% y el Indice de Masa Corporal (IMC) se situó en 25.1. Por último, observamos unos resultados muy similares en los distintos parámetros hallados mediante Impedanciometría y Densiometría, y más dispares si comparamos cualquiera de estos métodos con los antropométricos clásicos, especialmente en lo referente al compartimento graso y al método de Carter

The importance that the physical constitution, both the corporal composition and somatotype, it presents with relation to the sport performance has been widely studied in multiple athletic disciplines provided that there exit patterns of reference constructed from the individuals who form the elite of each sport. In case of karate, the shortage of works with sportsmen of our country animated to us to realize a study of a group of karatecas using technologies of Kinanthropometry, Bioelectrical-Impedance and Plethysmographic Densitometry. We have studied a wide group of karatecas of masculine sex, of ages includes between 20 and 30 years, with a minimal level of green belt, which they dedicate to the training at least 4 weekly hours and which they take part in competitions regionals, nationals and /or internationals. Our interest centred on calculating its Morphologic Protoype and its Corporal Composition, as well as on studing the degree of existing similarity between the diverse methods that evaluate the above mentioned corporal composition. Our group proved an average somatotype had (3.4-5.7-1.6), which it can be defined as Endo-Mesomorfic. In addition, we did not find sufficient biotipologycal homogeneity in our sample since the Somatotype Dispersion Index was of 3.05. As for the corporal composition, the percentage of fat calculated by the different methods, overcame clearly 10% and the Body Mass Index (BMI) placed in 25.1. Finally, we observed very similar results in the different parameters found by means of Impedance and Densiometry, and more unlike if we compared anyone of these method with the classic anthropometrics, specially in what concerns to the greasy compartment and the method of Carter

Factores que influyen sobre el vaciado gástrico de bebidas deportivas durante el ejercicio / Factors affectin gastric emptying of sport beverage during exercise

Los factores que contribuyen más decisivamente a la fatiga durante el ejercicio físico son el agotamiento de carbohidratos (CHO) y la deshidratación. El proceso final de rehidratación depende tanto del ritmo al cual la bebida abandona el estómago (vaciado gástrico) como de la absorción intestinal; también es conocido que la ingesta de una bebida de reposición adecuada durante el mismo retrasa la fatiga y mejora el rendimiento deportivo. Entre los múltiples factores que influyen en el vaciado gástrico encontramos características propias de la bebida ingerida (volumen, frecuencia de ingesta, densidad energética, osmolalidad, temperatura y pH de la solución), variables dependientes del ejercicio (intensidad y tipo de ejercicio), y otros factores (nivel de hidratación, estrés, cafeína, ritmo circadiano, condiciones ambientales, sexo femenino y fase del ciclo menstrual). Actualmente todos los estudios revisados defienden que las variables más determinantes del ritmo de vaciado gástrico son el volumen de bebida ingerido y la densidad energética de la misma. Existen grandes variaciones individuales en el ritmo de vaciado gástrico y en la tolerancia a la ingesta de importantes volúmenes de bebida, pero se recomienda ingerir bebidas de reposición adecuadas a la práctica deportiva antes, durante y/o después de las sesiones de entrenamiento o el ejercicio, pudiendo así mejorar la tolerancia

Carbohydrate deplection and dehydration are the most important factors affecting gastric emptying. The last process of rehydration depend as soon as gastric emptying rate as intestinal absorption; it is known that an adecuate sport beverage ingestion during exercise delay the onset of fatigue and improve performance. Between many factors affecting gastric emptying are characteristics of a sport drink (volume, frecuency ingestion, caloric content, osmolality, temperature and pH), factors depending of exercise (intensity and type), and others factors (hydration level, stress, caffeine, circadian rhythm, environment conditions, female and menstrual cycle). Actually, all literature revised state the more important factors affecting gastric emptying are the volume and the caloric content of ingested sport beverage. There is large individual variation in gastric emptying rate and tolerance to larger volumes. Training to drink an adecuate sport beverage before, during and/or after training sessions or exercise is recommended and could improve enhance tolerance