Impact of Melatonin Supplementation on Sports Performance and Circulating Biomarkers in Highly Trained Athletes: A Systematic Review of Randomized Controlled Trials.

Melatonin (N-acetyl-5 methoxytryptamine) is an indolic neurohormone that modulates a variety of physiological functions due to its antioxidant, anti-inflammatory, and immunoregulatory properties. Therefore, the purpose of this study was to critically review the effects of melatonin supplementation in sports performance and circulating biomarkers related to the health status of highly trained athletes. Data were obtained by performing searches in the following three bibliography databases: Web of Science, PubMed, and Scopus. The terms used were "Highly Trained Athletes", "Melatonin", and "Sports Performance", "Health Biomarkers" using "Humans" as a filter. The search update was carried out in February 2024 from original articles published with a controlled trial design. The PRISMA rules, the modified McMaster critical review form for quantitative studies, the PEDro scale, and the Cochrane risk of bias were applied. According to the inclusion and exclusion criteria, 21 articles were selected out of 294 references. The dose of melatonin supplemented in the trials ranged between 5 mg to 100 mg administered before or after exercise. The outcomes showed improvements in antioxidant status and inflammatory response and reversed liver damage and muscle damage. Moderate effects on modulating glycemia, total cholesterol, triglycerides, and creatinine were reported. Promising data were found regarding the potential benefits of melatonin in hematological biomarkers, hormonal responses, and sports performance. Therefore, the true efficiency of melatonin to directly improve sports performance remains to be assessed. Nevertheless, an indirect effect of melatonin supplementation in sports performance could be evaluated through improvements in health biomarkers.

Radon exposure and its influencing factors across 3,140 workplaces in Spain.

Indoor radon exposure increases the risk of lung cancer. Radon concentration in workplaces is regulated in EU countries, including Spain, based on a reference level of 300 Bq/m3. The objective of this study is to describe workplace radon exposure in Spain and its influencing factors. To do this, we collected long-term radon measurements with alpha track detectors in 3140 workplaces mainly located in radon prone areas. Radon concentration exceeded 300 Bq/m3 in 1 out of 5 workplaces. Median radon concentration was 107 Bq/m3 in radon prone areas, 28 Bq/m3 off radon prone areas, and 101 Bq/m3 globally for the complete sample. Our results indicate that excessive radon concentrations can be expected in radon prone areas at all floor levels, especially below ground. Floor level, working sector, and location significantly influence radon concentration. The highest radon concentrations were found in the Education & Culture sector, comprising schools, universities, libraries, or cultural centers. These results indicate that radon should no longer be considered a risk for marginal occupations, but a risk everyone has if located in a radon prone area. Immediate action, including radon testing and mitigation, is needed to protect workers in Spain against radon exposure. This is already mandatory since EU regulation for radon has been recently transposed in Spain. Competent authorities should enforce this regulation without further delay, and employers must address their responsibility and communicate with workers about this risk.

Comportamientos de miedo y ansiedad prequirúrgicos e intensidad de dolor percibida tras una artroscopia de rodilla / Fear and preoperative anxiety behaviour and pain intensity perceived after knee arthroscopy

Objetivo: Evaluar la relación entre la percepción del dolor tras una artroscopia de rodilla por cirugía mayor ambulatoria medida a las 24 h y los comportamientos de miedo y ansiedad prequirúrgicos. Métodos: Estudio observacional de tipo transversal, realizado a 40 sujetos adultos sometidos a artroscopia de rodilla en el área quirúrgica del Hospital de Cantoblanco (Hospital Universitario La Paz) de Madrid. Las conductas de miedo y ansiedad se evaluaron mediante los cuestionarios validados de catastrofización ante el dolor, kinesiofobia y ansiedad. El dolor pre y posquirúrgico, así como la discapacidad percibida prequirúrgica, se valoraron mediante la escala verbal numérica. Resultados: La edad media de la muestra (22 hombres y 18 mujeres) fue de 52,85±14,21, sin que hubiese diferencias significativas entre género. No se encontraron datos estadísticamente significativos para la asociación entre las variables de kinesiofobia, ansiedad y catastrofismo ante el dolor con la intensidad del dolor percibido por el paciente posquirúrgico de artroscopia de rodilla. La duración de la cirugía tiene, según nuestro estudio, una correlación con el dolor posquirúrgico inmediato (r=0,468; p=0,002), así como existe una relación entre la edad y la intensidad del dolor a las 24 h (r=−0,329; p=0,038), y entre la edad y la discapacidad percibida (r=−0,314; p=0,049). Se obtiene así mismo una asociación entre la escala de catastrofismo y la de kinesiofobia (r=0,337; p=0,033). Conclusiones: Los factores de miedo y ansiedad prequirúrgicos, así como el catastrofismo y la kinesiofobia, no han resultado estar asociados con el dolor posquirúrgico en nuestro estudio. La duración de la intervención muestra una correlación con el dolor posquirúrgico

OBJECTIVE: The aim of this study was to investigate the short-term (24hours) association between postoperative pain and preoperative psychological variables (anxiety, pain catastrophizing and kinesiophobia) in a sample of knee arthroscopy ambulatory surgery. METHODS: Observational cross-sectional study, conducted with 40 adult subjects who underwent knee arthroscopy in the surgical area of Cantoblanco Hospital (Hospital Universitario La Paz) in Madrid. The fear-avoidance beliefs and anxiety were assessed using validated questionnaires of pain catastrophizing, kinesiophobia and anxiety. Pre and post-surgical pain and perceived disability were evaluated by the Verbal Numeric Scale. RESULTS: Mean age of the sample (22 men and 18 women) was 52.85±14.21 without significant differences between gender. No statistically significant data for the association between variables of kinesiofobia, anxiety and pain catastrophizing and the intensity of perceived pain by the postoperative knee arthroscopy patient were found. Length of surgery in our study has a correlation with the immediate post-surgical pain (r=0.468; P=.002) and there is a relationship between age and pain intensity at 24hours (r=−0.329; P=.038), and between age and perceived disability (r=−0.314; P=.049). An association between catastrophizing and kinesiophobia scales (r=0.337; P=.033) is obtained likewise. CONCLUSIONS: In conclusion, preoperative fear-avoidance beliefs like pain anxiety or pain catastrophizing and kinesiophobia were not associated with acute postoperative pain in our study. Analyses of secondary pain related outcomes, however, indicated that reduced time of surgery may contribute to enhance clinical postoperative pain. If confirmed and replicated in larger samples, this may potentially enable clinicians to improve postoperative pain management in future patients

[Fear and preoperative anxiety behaviour and pain intensity perceived after knee arthroscopy]. / Comportamientos de miedo y ansiedad prequirúrgicos e intensidad de dolor percibida tras una artroscopia de rodilla.

OBJECTIVE: The aim of this study was to investigate the short-term (24hours) association between postoperative pain and preoperative psychological variables (anxiety, pain catastrophizing and kinesiophobia) in a sample of knee arthroscopy ambulatory surgery. METHODS: Observational cross-sectional study, conducted with 40 adult subjects who underwent knee arthroscopy in the surgical area of Cantoblanco Hospital (Hospital Universitario La Paz) in Madrid. The fear-avoidance beliefs and anxiety were assessed using validated questionnaires of pain catastrophizing, kinesiophobia and anxiety. Pre and post-surgical pain and perceived disability were evaluated by the Verbal Numeric Scale. RESULTS: Mean age of the sample (22 men and 18 women) was 52.85±14.21 without significant differences between gender. No statistically significant data for the association between variables of kinesiofobia, anxiety and pain catastrophizing and the intensity of perceived pain by the postoperative knee arthroscopy patient were found. Length of surgery in our study has a correlation with the immediate post-surgical pain (r=0.468; P=.002) and there is a relationship between age and pain intensity at 24hours (r=-0.329; P=.038), and between age and perceived disability (r=-0.314; P=.049). An association between catastrophizing and kinesiophobia scales (r=0.337; P=.033) is obtained likewise. CONCLUSIONS: In conclusion, preoperative fear-avoidance beliefs like pain anxiety or pain catastrophizing and kinesiophobia were not associated with acute postoperative pain in our study. Analyses of secondary pain related outcomes, however, indicated that reduced time of surgery may contribute to enhance clinical postoperative pain. If confirmed and replicated in larger samples, this may potentially enable clinicians to improve postoperative pain management in future patients.

Rehabilitación respiratoria / Pulmonary Rehabilitation

La rehabilitación respiratoria (RR) ha demostrado mejorar la disnea, la capacidad de esfuerzo y la calidad de vida relacionada con la salud en los pacientes con enfermedad pulmonar obstructiva crónica (EPOC). En otras enfermedades distintas de la EPOC también ha mostrado beneficios, aunque el grado de evidencia es menor. Los componentes fundamentales de los programas de RR son el entrenamiento muscular, la educación y la fisioterapia respiratoria, siendo aconsejable también contemplar la terapia ocupacional, el soporte psicosocial y la intervención nutricional. Los programas domiciliarios han demostrado igual eficacia que los hospitalarios. La duración de los programas de RR no debe ser inferior a 8 semanas o 20 sesiones. La RR iniciada precozmente, incluso durante las exacerbaciones, ha demostrado ser eficaz y segura. La utilización de oxígeno o ventilación no invasiva durante el entrenamiento es controvertida y dependiente de la situación del paciente. En el momento actual desconocemos cuál es la mejor estrategia para mantener los beneficios de la RR a largo plazo. Una mayor duración de los programas o la telemedicina podrían ser claves para prolongar los resultados conseguidos

Pulmonary rehabilitation (PR) has been shown to improve dyspnea, exercise capacity and health-related quality of life in patients with chronic obstructive pulmonary disease (COPD). PR has also shown benefits in diseases other than COPD but the level of evidence is lower. The fundamental components of PR programs are muscle training, education and chest physiotherapy. Occupational therapy, psychosocial support and nutritional intervention should also be considered. Home programs have been shown to be as effective as hospital therapy. The duration of rehabilitation programs should not be less than 8 weeks or 20 sessions. Early initiation of PR, even during exacerbations, has proven safe and effective. The use of oxygen or noninvasive ventilation during training is controversial and dependent on the patient's situation. At present, the best strategy for maintaining the benefits of PR in the long term is unknown. Longer PR programs or telemedicine could play a key role in extending the results obtained

Pulmonary rehabilitation. Sociedad Española de Neumología y Cirugía Torácica (SEPAR).

Pulmonary rehabilitation (PR) has been shown to improve dyspnea, exercise capacity and health-related quality of life in patients with chronic obstructive pulmonary disease (COPD). PR has also shown benefits in diseases other than COPD but the level of evidence is lower. The fundamental components of PR programs are muscle training, education and chest physiotherapy. Occupational therapy, psychosocial support and nutritional intervention should also be considered. Home programs have been shown to be as effective as hospital therapy. The duration of rehabilitation programs should not be less than 8 weeks or 20 sessions. Early initiation of PR, even during exacerbations, has proven safe and effective. The use of oxygen or noninvasive ventilation during training is controversial and dependent on the patient's situation. At present, the best strategy for maintaining the benefits of PR in the long term is unknown. Longer PR programs or telemedicine could play a key role in extending the results obtained.

Clinical, biochemical, and molecular studies in pyridoxine-dependent epilepsy. Antisense therapy as possible new therapeutic option.

PURPOSE: Pyridoxine-dependent epilepsy seizure (PDE; OMIM 266100) is a disorder associated with severe seizures that can be controlled pharmacologically with pyridoxine. In the majority of patients with PDE, the disorder is caused by the deficient activity of the enzyme α-aminoadipic semialdehyde dehydrogenase (antiquitin protein), which is encoded by the ALDH7A1 gene. The aim of this work was the clinical, biochemical, and genetic analysis of 12 unrelated patients, mostly from Spain, in an attempt to provide further valuable data regarding the wide clinical, biochemical, and genetic spectrum of the disease. METHODS: The disease was confirmed based on the presence of α-aminoadipic semialdehyde (α-AASA) in urine measured by liquid chromatography tandem mass spectrometry (LC-MS/MS) and pipecolic acid (PA) in plasma and/or cerebrospinal fluid (CSF) measured by high performance liquid chromatography (HPLC)/MS/MS and by sequencing analysis of messenger RNA (mRNA) and genomic DNA of ALDH7A1. KEY FINDINGS: Most of the patients had seizures in the neonatal period, but they responded to vitamin B6 administration. Three patients developed late-onset seizures, and most patients showed mild-to-moderate postnatal developmental delay. All patients had elevated PA and α-AASA levels, even those who had undergone pyridoxine treatment for several years. The clinical spectrum of our patients is not limited to seizures but many of them show associated neurologic dysfunctions such as muscle tone alterations, irritability, and psychomotor retardation. The mutational spectrum of the present patients included 12 mutations, five already reported (c.500A>G, c.919C>T, c.1429G>C c.1217_1218delAT, and c.1482-1G>T) and seven novel sequence changes (c.75C>T, c.319G>T, c.554_555delAA, c.757C>T, c.787 + 1G>T, c.1474T>C, c.1093-?_1620+?). Only one mutation, p.G477R (c.1429G>C), was recurrent; this was detected in four different alleles. Transcriptional profile analysis of one patient's lymphoblasts and ex vivo splicing analysis showed the silent nucleotide change c.75C>T to be a novel splicing mutation creating a new donor splice site inside exon 1. Antisense therapy of the aberrant mRNA splicing in a lymphoblast cell line harboring mutation c.75C>T was successful. SIGNIFICANCE: The present results broaden our knowledge of PDE, provide information regarding the genetic background of PDE in Spain, afford data of use when making molecular-based prenatal diagnosis, and provide a cellular proof-of concept for antisense therapy application.