Effect of follicle size on hormonal status of follicular fluid, oocyte ATP content, and in vitro embryo production in prepubertal sheep.

The aim of this study was to assess the effect of follicular size on estradiol (E2) and progesterone (P4) levels in intrafollicular fluid, ATP content in oocytes, and the embryo development rate in prepubertal sheep. Slaughterhouse ovaries were dissected to recover the follicles, which were classified according to the follicle diameter as <3 mm (n = 20) and ≥3 mm (n = 17). Then, follicular fluid was obtained and analyzed by radioimmunoassay to determine the E2 and P4 concentrations. Another group of ovaries was used to recover cumulus-oocyte complexes according to follicle size. In vitro maturation (IVM), in vitro fertilization (IVF), and embryo culture were performed using standard procedures, and ATP level was assessed at 0 and 24 h of IVM. Intrafollicular concentrations of E2 and P4 and E2:P4 ratio were higher in ≥3 mm (18.7 ± 5.9 ng/mL, 7.8 ± 1.2 ng/mL, and 3.6 ± 1.3, respectively) than <3 mm (1.8 ± 0.4 ng/mL, 2.6 ± 0.3 ng/mL and 0.9 ± 0.3, respectively) follicles. The rate of ATP increased during IVM and was higher in oocytes from ≥3 mm than <3 mm (22.4 ± 0.7 and 8.6 ± 2.2-fold change; respectively) follicles. After IVF, the blastocyst development was higher in oocytes recovered from ≥3 mm (11.1 ± 0.9%) than from <3 mm (6.5 ± 0.7%) follicles. These results indicate an improvement in the competence and development of oocytes from ≥3 mm follicles with a higher E2:P4 ratio. Thus, this ratio could be used as reference to design IVM medium and to enhance the in vitro embryo production in lambs.

Assessing physical activity in people with mental illness: 23-country reliability and validity of the simple physical activity questionnaire (SIMPAQ).

BACKGROUND: Physical inactivity is a key contributor to the global burden of disease and disproportionately impacts the wellbeing of people experiencing mental illness. Increases in physical activity are associated with improvements in symptoms of mental illness and reduction in cardiometabolic risk. Reliable and valid clinical tools that assess physical activity would improve evaluation of intervention studies that aim to increase physical activity and reduce sedentary behaviour in people living with mental illness. METHODS: The five-item Simple Physical Activity Questionnaire (SIMPAQ) was developed by a multidisciplinary, international working group as a clinical tool to assess physical activity and sedentary behaviour in people living with mental illness. Patients with a DSM or ICD mental illness diagnoses were recruited and completed the SIMPAQ on two occasions, one week apart. Participants wore an Actigraph accelerometer and completed brief cognitive and clinical assessments. RESULTS: Evidence of SIMPAQ validity was assessed against accelerometer-derived measures of physical activity. Data were obtained from 1010 participants. The SIMPAQ had good test-retest reliability. Correlations for moderate-vigorous physical activity was comparable to studies conducted in general population samples. Evidence of validity for the sedentary behaviour item was poor. An alternative method to calculate sedentary behaviour had stronger evidence of validity. This alternative method is recommended for use in future studies employing the SIMPAQ. CONCLUSIONS: The SIMPAQ is a brief measure of physical activity and sedentary behaviour that can be reliably and validly administered by health professionals.

Nox1-derived oxidative stress as a common pathogenic link between obesity and hyperoxaluria-related kidney injury.

Specific relationships among reactive oxygen species, activation pathways, and inflammatory mechanisms involved in kidney injury were assessed in a combined model of obesity and hyperoxaluria. Male Wistar rats were divided into four groups: Control, HFD (high fat diet), OX (0.75% ethylene glycol), and HFD + OX (combined model) Changes in basal O2- levels were evaluated by chemiluminescence in renal interlobar arteries and renal cortex. Furthermore, the effect of different inhibitors on NADPH-stimulated O2- generation was assessed in renal cortex. Oxidative stress sources, and local inflammatory mediators, were also determined, in parallel, by RT-PCR, and correlated with measures of renal function, urinary biochemistry, and renal structure. Rats from the HFD group developed overweight without lipid profile alteration. Tubular deposits of crystals were seen in OX and severely enhanced in HFD + OX groups along with a significantly higher impairment of renal function. Basal oxidative stress was increased in renal cortex of OX rats and in renal arteries of HFD rats, while animals from the combined HFD + OX group exhibited the highest levels of oxidative stress in renal cortex, derived from xanthine oxidase and COX-2. NADPH oxidase-dependent O2- generation was elevated in renal cortex of the OX group and markedly enhanced in the HFD + OX rats, and associated to an up-regulation of Nox1 and a down-regulation of Nox4 expression. High levels of oxidative stress in the kidney, of OX and HFD + OX groups were also associated to an inflammatory response mediated by an elevation of TNFα, COX-2, NFκB1 MCP-1, and OPN. Oxidative stress is a key pathogenic factor in renal disease associated to hyperoxaluria and a common link underlying the exacerbated inflammatory response and kidney injury found under conditions of both obesity and hyperoxaluria. Nox1 pathway must be considered as a potential therapeutic target.

Sensor system based on flexible screen-printed electrodes for electrochemical detection of okadaic acid in seawater.

The monitoring of marine dinophysistoxin okadaic acid in seawater can serve as an early alert system for preventing the potential negative effects this toxin can have on the food industry and human health in general. A disposable sensor system for electrochemical detection of this toxin has been developed using screen-printed electrodes. The method described is based on the inhibition of protein phosphatase type 2A by okadaic acid, evaluating the enzyme activity. p-Nitrophenyl phosphate, 4-methylumbelliferyl phosphate and phenyl phosphate have been tested as substrates achieving good limits of detection of 2.7·10-12 M of okadaic acid. The proposed method has been successfully applied to okadaic acid determination in seawater samples. A study of divalent cations present in seawater that can interfere with the measurement has been carried out. The electrode systems were printed on both rigid and textile backing materials to observe the influence of those materials on the final performance of the sensor.

Ideal cardiovascular health and its association with sedentary behaviour and fitness in psychiatric patients. The PsychiActive project.

BACKGROUND AND AIMS: Ideal cardiovascular health (CVH) was defined as meeting ideal levels of 4 health behaviours (smoking, body mass index, physical activity, and diet) and 3 biological factors (blood pressure, total cholesterol, and glucose) and is inversely related to cardiovascular disease and mortality. However, the prevalence of ideal CVH in patients with severe mental illness and the possible independent associations of sedentary behaviour and fitness with CVH score are unexplored. METHODS AND RESULTS: This study included 142 (34 women) outpatients with severe mental illness (primarily schizophrenia, n = 92). CVH was evaluated according to the American Heart Association guidelines. Sedentary behaviour, cardiorespiratory fitness, and muscular strength were measured by an activity-monitor, the 6-min walk test, and handgrip dynamometry. Cardiorespiratory fitness and strength values were combined in a composite fitness score. The prevalence of ideal CVH was: non-smoking (47.9%), body mass index (16.9), physical activity (83.1%), diet (10.4%), blood pressure (40.4%), total cholesterol (62.9%), and plasma glucose (66.7%). Low levels of sedentary behaviour and high cardiorespiratory, strength, and composite fitness score were associated with meeting the ideal threshold in most CVH metrics and having higher global CVH score; however, only cardiorespiratory and composite fitness score remained significantly related to global CVH score independent of sedentary behaviour and multiple confounders. CONCLUSIONS: Patients with severe mental illness generally have low prevalence of ideal CVH metrics, especially diet and body mass index. Additionally, our findings suggest the need or considering cardiorespiratory fitness, regardless of sedentary behaviour, to promote ideal CVH in this population.

La triada oscura de la personalidad y sus implicaciones en el deporte: Una revision sistemática / The dark triad of personality and its psychological implications in sport: A systematic review / O triade sombria da personalidade e suas implicações psicológicas no esporte: Uma revisão sistemática

La Triada Oscura de la personalidad (TOP) ha suscitado el interés creciente de la comunidad científica, debido a las aportaciones explicativas que ofrecen sus características a factores ampliamente investigados por los estudios de personalidad. Narcisismo, maquiavelismo y psicopatía forman parte de una constelación de factores que subyacen en variables tanto de autoconcepto, de ajuste psicológico y de relación social. Han sido escasos los trabajos que han estudiado tales constructos en contextos deportivos, principalmente centrados en conductas inmorales, de incapacidad para la autorregulación de impulsos, o de configuración de creencias perfeccionistas orientadas al éxito deportivo. Con el propósito de reflejar, a través de la revision sistemática de los textos científicos publicados, se describen los principales vínculos entre las dimensiones de la TO y otras variables en deportistas. Se han revisado los artículos originales en inglés y español publicados en las bases de datos electrónicas Web of Science, ERIC, PsycINFO, ProQuest, SCOPUS, Dialnet, PubMed e ISOC, teniendo en cuenta los principios establecidos por la declaración PRISMA y AMSTAR para la descripción cualitativa y cuantitativa en revisiones sistemáticas. De los 72 artículos identificados, sólo 24 cumplieron los criterios de inclusión establecidos. Los entrenadores y deportistas son las figuras que más se han asociado al estudio de los rasgos de la TOP, y las variables más vinculadas con motivación, perfeccionismo, liderazgo, actitudes hacia trampas, o el locus de control

The Dark Triad of Personality (DTP) has received a growing interest by the scientific community, due to the explanatory contributions offered by its characteristics to factors widely investigated in the research on personality. Narcissism, Machiavellianism and Psychopathy configure a constellation of factors that underlie variables such as self-concept, psychological adjustment and social relationships. There is a lack of studies on such constructs in sports contexts, and they are mainly focused on immoral behavior, inability to self-regulate impulses and configurations of perfectionist beliefs regarding athletic success. With the purpose of reflecting the published papers within a systematic review, the main links between the dimensions of the DTP and other variables in athletes are described. Original articles in English and Spanish published in the platforms and electronic databases Web of Science, Scopus, ProQuest, MEDline, and EBSCO-HOST were reviewed, taking into account the principles established by the PRISMA and AMSTAR statements for the qualitative and quantitative description of findings in systematic reviews. Of the 72 articles identified, 29 met the established inclusion criteria. Coaches and athletes are the figures that have received greater interest in the study of DTP traits. The variables most related to DTP are exercise dependence, perfectionism, leadership, aggressivity, attitudes towards cheating and locus of control

A Tríade Sombria da Personalidade (TSP) despertou o crescente interesse da comunidade científica, devido às contribuições explicativas oferecidas por suas características a fatores amplamente investigados por estudos de personalidade. O Narcisismo, o Maquiavelismo e a Psicopatia fazem parte de uma constelação de fatores subjacentes a variáveis como autoconceito, ajuste psicológico e relacionamento social. Há uma falta de estudos sobre tais construtos em contextos esportivos, e eles são principalmente focados em comportamento imoral, incapacidade de auto-regular impulsos e configurações de crenças perfeccionistas em relação ao sucesso atlético. Com o propósito de refletir com uma revisão sistemática de textos científicos publicados, as principais relaçãos entre as dimensões do TSP e outras variáveis em atletas são descritos. Os artigos originais em inglês e espanhol publicados nas bases de datos eletrônicas Web of Science, Scopus, ProQuest, MEDline e EBSCO-HOST foram revisados, levando em consideração os princípios estabelecidos pelas declarações PRISMA e AMSTAR para o descrição qualitativa e quantitativa dos resultados em revisões sistemáticas. Dos 72 artigos identificados, 29 atenderam aos critérios de inclusão estabelecidos. Treinadores e atletas são os indivíduos que receberam maior interesse no estudo das características do TSP. As variáveis mais relacionadas à TSP são dependência do exercício, perfeccionismo, liderança, agressividade, atitudes frente ao engano e locus de controle

Comparison of backing materials of screen printed electrochemical sensors for direct determination of the sub-nanomolar concentration of lead in seawater.

An anodic stripping voltammetric method is reported in this study for the determination of sub-nanomolar Pb concentration using disposable sensors, each consisting of three (counter, working and reference) screen-printed electrodes. Sensor performance was optimized for the determination of Pb through several surface modifications, by using single-walled carbon nanotubes, electro-reduced graphene oxide and gold nanoparticles. A scanning electron microscopy study of the deposition of electrogenerated gold nanoparticles of various sizes on the working electrode surface showed that spherical nanoparticles of around 100 nm provided the best results. The modification of working electrodes with graphene and gold nanoparticles permitted the determination of Pb2+ in seawater (Detection Limit: 3.21·10-10 M) without modifying the pH of the sample. The electrode systems were printed on both rigid and textile backing materials, to observe the influence of those materials on the final performance of the sensor.

Non-osteogenic muscle hypertrophy in children with McArdle disease.

INTRODUCTION: McArdle disease is an inborn disorder of muscle glycogen metabolism that produces exercise intolerance, and has been recently associated with low values ​​of lean mass (LM) and bone mineral content (BMC) and density (BMD) in affected adults. Here we aimed to study whether this bone health problem begins in childhood. METHODS: Forty children and adolescents were evaluated: 10 McArdle disease and 30 control children (mean age of both groups, 13 ± 2y). Body composition was evaluated by dual-energy X-ray absorptiometry and creatine kinase (CK) levels were determined in the patients as an estimate of muscle damage. RESULTS: Legs bone mass was significantly lower in patients than in controls (-36% for BMC and -22% for BMD). Moreover, patients had significantly higher LM values in the legs than controls, whereas no difference was found for fat mass. CK levels were positively associated with LM in McArdle patients. A correlation was found between LM and BMD variables in the control group but not in McArdle patients. CONCLUSION: We have identified a 'non-osteogenic muscle hypertrophy' in children with McArdle disease. This phenomenon warrants special attention since low osteogenesis at an early age predicts a high risk for osteoporosis later in life.

Development and psychometric evaluation of a health questionnaire on back care knowledge in daily life physical activities for adolescent students.

PURPOSE: The most relevant musculoskeletal problems are related with back health. Study instruments have been designed for adult patient population but not for school-aged children. The aim of this study was to develop and evaluate the psychometric properties of a questionnaire to assess adolescents' level of back care knowledge in daily life physical activities. METHODS: Participants were 171 adolescents from secondary schools. The questionnaire was made up of 24 questions. A Delphi method was used for test validation. Cronbach's alpha, test-retest, Wilcoxon signed-rank and Bland-Altman graph were used to evaluate the instrument reliability. RESULTS: Cronbach's alpha (α = 0.82) showed a strong internal consistency. Test-retest was excellent for total score (0.76) and moderate to excellent (0.54-0.76) for seven score conceptual categories with good results of standard error of the mean and minimal detectable change. No differences were found between test 1 and test 2 except for the standing posture scores. CONCLUSION: The questionnaire showed acceptable psychometric values. Results showed that this questionnaire is a good instrument to assess adolescent's back care knowledge.

Match-play activity profile in professional soccer players during official games and the relationship between external and internal load.

AIM: The aim was to quantify for the first time the physical and physiological profile of professional soccer players in official games using GPS and heart rate (HR) response. METHODS: Thirty professional soccer players were investigated during a half in competitive club level matches (N.=348) using GPS devices. RESULTS: The relative total distance was 118.9±10.7 m∙min(-1) and player's Work-To-Rest Ratio was 2.1:1. Defenders covered the lowest total distance, while Second-Strikers (2(nd)S) and Wide-Midfielders (W-MD) traveled the greatest total distance. Defenders presented the lowest Work-To-Rest Ratio values. Playing position also impacted on all sprinting performance results, except in average sprint distance and time of sprint. The number of sprints and repeated-sprint sequences recorded by the W-MD and Strikers (S) were significantly greater than any other group. The average HR recorded was 87.1%HRmax and the relationship between the external and internal load value (Effindex) was 1.4 with significant differences in both between playing positions. W-MD recorded a significantly smaller average HR than any other group and Centre-Backs showed a significantly smaller Effindex value than any other group. Conversely, W-MD showed a significantly greater Effindex value than any other group, except the 2(nd)S. CONCLUSION: This study has verified a number of statistically significant differences between the different playing positions. Coaches should be focused on the specific physical and physiological requirements of the playing positions to optimize the training prescription in soccer. The relationships between external and internal load measures among position-specific indicates that players with less overall running performance during match-play were the worst in Effindex.

Fertilization capacity of cryopreserved Iberian ibex epididymal sperm in a heterologous in vitro fertilization assay.

In vitro fertilization (IVF) can be used to assess the fertilization capacity of sperm. Heterologous IVF may be useful when assessing that of wild animals as it is often difficult to obtain adequate numbers of naturally corresponding oocytes. The aim of the present study was to assess the fertilization capacity of frozen-thawed ibex epididymal spermatozoa via heterologous IVF involving the oocytes of prepubertal domestic goats. The effect on fertilization and embryo development of adding oestrous sheep serum (ESS) to the fertilization medium was also examined. Cumulus-oocyte complexes (COCs) were matured in TCM-199 for 24-27 h at 38.5°C in a 5% CO2 in air atmosphere. Frozen-thawed epididymal spermatozoa were selected by density gradient centrifugation. After maturation, the oocytes were co-incubated with spermatozoa in synthetic oviductal fluid (SOF) with different concentrations of ESS: SOF-C (0%), SOF-2 (2%) and SOF-20 (20%). At 17 h post-insemination (hpi), zygotes with one female and one male pronucleus (2PN) were categorised as normal; zygotes with 3PN were recorded as polyspermic, and oocytes with 1PN as asynchronous. Cleavage and blastocyst development were assessed at 48 and 168 hpi respectively. The percentage of zygotes with 2PN was higher in the SOF-2 than in the SOF-20 treatment group (27.7% versus 2.9% P < 0.05). The percentage of blastocysts formed with the SOF-C, SOF-2 and SOF-20 treatments were 1.1%, 7.5% and 0% respectively. These results show that the presence of 2% ESS achieves better results than the use of no serum or the standard 20% concentration. Heterologous IVF may be an effective method for predicting the fertilization capacity of ibex spermatozoa, and therefore perhaps that of other wild mountain ungulates.

Current status of in vitro embryo production in sheep and goats.

Sheep and goat production is an important economic activity in Spain with an increasing interest in milk production. Multiovulation and Embryo Transfer (MOET) and In vitro Embryo Production (IVEP) are assisted reproductive technologies aimed at increasing the genetic diffusion of females. In vitro embryo production is a multi-step methodology comprising the following procedures: (i) In vitro Maturation (IVM) of oocytes recovered directly from the follicles, (ii) In vitro Fertilization (IVF) or co-incubation of capacitated spermatozoa with in vitro matured oocytes and (iii) In vitro culture (IVC) of zygotes up to the blastocyst stage. In vitro embryo production from oocytes recovered from prepubertal females is called JIVET (Juvenile in vitro Embryo Transfer) and allows shortened generation intervals and increased genetic gain. Embryo production together with embryo cryoconservation would allow large-scale embryo marketing, a pathogen-free genetic movement and easier and cheaper germplasm commercial transactions. Commercial Embryo activity in small ruminants is low compared to cows in the European Union (data from the European Embryo Transfer Association) and in the world (data from the International Embryo Transfer Association). There is less IVEP research in small ruminants compared to other livestock species. The aim of this review was to provide an overview of the current status of IVEP of small ruminant with an emphasis on (i) description of the main methodologies currently used for IVM, IVF and IVC of embryos (ii) comparing procedures and outputs from JIVET and IVEP of adult females and (iii) the future research perspectives of this technology.

Sperm characteristics and heterologous in vitro fertilisation capacity of Iberian ibex (Capra pyrenaica) epididymal sperm, frozen in the presence of the enzymatic antioxidant catalase.

The aim of this work was to evaluate the protective effect of catalase (CAT) on frozen/thawed ibex epididymal sperm recovered post mortem, and to detect any harmful effect this might have on sperm fertilisation capacity. Epididymal spermatozoa were diluted using a Tris-citric acid-glucose medium (TCG) composed of 3.8% Tris (w/v), 2.2% citric acid (w/v), 0.6% glucose (w/v), 5% glycerol (v/v), and 6% egg yolk (v/v). Sperm masses from the right epididymis were diluted with TCG medium, while those from the left were diluted with TCG medium supplemented with 200IU/mL CAT. Heterologous in vitro fertilisation (IVF) was used to assess the fertilisation capacity of this sperm. The addition of CAT to the extender did not improve frozen/thawed sperm variables. Moreover, a reduced fertilisation capacity was detected: sperm diluted with TCG provided 25.5% 2PN zygotes, while just 13.2% was recorded for that diluted with TCG-CAT (P<0.01). The percentage of cleaved embryos at 48hpi was higher (P<0.01) with the TCG sperm than with the TCG-CAT sperm (16.7% vs. 7.6%). The use of 200IU/mL CAT as an additive cannot, therefore, be recommended for the preservation of ibex epididymal sperm. Other antioxidants should, however, be tested in both this and related wild mountain ungulates.

In vitro developmental competence of prepubertal goat oocytes cultured with recombinant activin-A.

The present study was designed to evaluate the effect of activin-A during the in vitro oocyte maturation (IVM) and in vitro embryo culture (IVC) on nuclear maturation, blastocyst yield and blastocyst quality of prepubertal goat oocytes. In Experiment 1, three groups of oocytes were used during the IVM of prepubertal goat oocytes to determine the optimal concentration of recombinant human activin-A added to the maturation medium. Cumulus-oocyte complexes were matured in an IVM medium containing 0, 10 and 100 ng/ml (groups A0, A10 and A100), fertilized and in vitro cultured using standard procedures. In Experiment 2, the addition of 10 ng/ml activin-A at IVM (A10A0), IVC (A0A10) or IVM+IVC (A10A10) was studied and compared with the control group (A0A0). Results of the first experiment demonstrated that the addition of activin-A yielded similar percentages of maturation (⩽71.0%) and blastocyst formation rates (⩽24.9%) than the control group (A0). Experiment 2 showed that exposure of prepubertal goat oocytes to an IVC medium containing 10 ng/ml activin-A (A0A10) significantly increased the rates of development to the blastocyst stage, as compared with the control group (A0A0) (19.5±2.21% v. 13.1±2.37%, respectively; P<0.05). With regard to the blastocyst quality, total number of cells, inner cell mass (ICM) and trophectoderm of prepubertal goat embryos produced in the presence of activin-A did not differ significantly among experimental groups. In summary, these results indicate that supplementation of the IVC medium with activin-A enhances embryo development of prepubertal goat oocytes.

Developmental competence and embryo quality of small oocytes from pre-pubertal goats cultured in IVM medium supplemented with low level of hormones, insulin-transferrin-selenium and ascorbic acid.

The aim of this study was to test the effect of insulin-transferrin-selenium (ITS) and L-ascorbic acid (AA) supplementation and the hormonal level during in vitro maturation (IVM) of small oocytes from pre-pubertal goat on the blastocyst yield and quality. Concretely, we used four maturation media: conventional IVM medium (CM), growth medium (GM: CM+ITS+AA and low level of hormones), modified CM (mCM: CM with low level of hormones) and modified GM (mGM: CM+ITS+AA and normal level of hormones). Cumulus-oocyte complexes (COCs) were classified into two categories according to oocyte diameter: <125 µm and ≥ 125 µm. Large oocytes were matured 24 h in CM (Treatment A). Small oocytes were matured randomly in six experimental groups: Treatment B: 24 h in CM; Treatment C: 12 h in GM and 12 h in CM; Treatment D: 24 h in mGM; Treatment E: 12 h in mGM and 12 h in CM; Treatment F: 12 h in mCM and 12 h in CM; and Treatment G: 12 h in GM and 12 h in mGM. After IVM, oocytes were fertilized and cultured for 8 days. The blastocyst quality was assessed by the survival following vitrification/warming and the mean cell number. When different maturation media were combined, the blastocyst rate did not improve. The large oocytes produced the highest blastocysts yield. However, the culture of small oocytes in GM (53.3%) enhanced the post-warming survival of blastocysts compared to large oocytes matured in CM (35.7%). In conclusion, IVM of pre-pubertal goat small oocytes in GM would be useful to improve the quality of in vitro-produced blastocysts.

[Teleradiology in the emergency department: opportunity and danger]. / Telerradiología en la urgencia, oportunidad y amenaza.

Teleradiology is an established fact in developed countries. It has been the subject of intense professional and even legal debate in recent years because the quality of care and the role of the radiologist as a medical specialist are at stake. The opportunities and the dangers involved in teleradiology are discussed in this article. The use of teleradiology in certain circumstances in the emergency department can result in significant benefits when done right; however, it is evident that poorly implemented teleradiology services can lead to significant decreases in the quality of care (for example when the aim is to provide a low cost reporting service through outsourcing). Radiologists must use their knowledge and collaboration to ensure that they have the main role in the design, management, and performance of teleradiology services. The stance of our scientific societies together with the legal and regulatory frameworks must be the pillars that support teleradiology as a medical act.

Telerradiología en la urgencia, oportunidad y amenaza / Teleradiology in the emergency department: opportunity and danger

La telerradiología es una realidad implantada en los países desarrollados, y ha suscitado un debate profesional e incluso legal intenso en los últimos años, ya que están en juego la calidad asistencial y el papel del radiólogo como especialista médico. La oportunidad y la amenaza que suponen la telerradiología son los aspectos que desarrollamos en este artículo: su utilización en determinadas circunstancias en las urgencias puede aportar importantes beneficios cuando se realiza adecuadamente; pero es evidente que mal implantada puede suponer una importante merma de la calidad asistencial, por ejemplo cuando su objetivo es dar un servicio de informes a bajo precio recurriendo a la externalización. El radiólogo, desde el conocimiento y la colaboración, debe mantener un papel protagonista en su diseño, dirección y realización. El posicionamiento de nuestras sociedades científicas, el marco normativo y legal deben ser los pilares para la realización de la telerradiología como un acto médico (AU)

Teleradiology is an established fact in developed countries. It has been the subject of intense professional and even legal debate in recent years because the quality of care and the role of the radiologist as a medical specialist are at stake. The opportunities and the dangers involved in teleradiology are discussed in this article. The use of teleradiology in certain circumstances in the emergency department can result in significant benefits when done right; however, it is evident that poorly implemented teleradiology services can lead to significant decreases in the quality of care (for example when the aim is to provide a low cost reporting service through outsourcing). Radiologists must use their knowledge and collaboration to ensure that they have the main role in the design, management, and performance of teleradiology services. The stance of our scientific societies together with the legal and regulatory frameworks must be the pillars that support teleradiology as a medical act (AU)

The validity of incremental exercise testing in discriminating of physiological profiles in elite runners.

The goal of this study was to determine whether traditional ergoespirometric incremental exercise testing carried out to the point of exhaustion could be useful in distinguishing the physiological profiles of elite runners that compete in races that lasted about 8 minutes versus those that lasted about 2 hours. Ten male marathon runners (performance time: 2:12:04, coefficient of variation (CV) = 2.33%) and 8 male 3000 m steeplechase runners (performance time: 8:37.83, CV = 2.12%) performed an incremental test on the treadmill (starting speed 10 km·h-1; increments, 2 km·h-1; increment duration, 3 min to exhaustion). Heart rate (HR), VO2, and lactate concentrations were measured at the end of each exercise level. At maximal effort, there were no differences between the groups regarding VO2max and maximal HR; however, the workload time, vVO2max and peak treadmill velocity were significantly higher in the 3000 m steeplechase group (p<0.05). At submaximal effort, there were no significant differences between groups for VO2 (ml·kg-1·min-1), HR, or lactate. Our results show that this type of testing was not sufficient for discriminating the physiological profiles of elite runners who competed in middle-distance versus long-distance events (e.g. in the marathon and the 3000 m steeplechase).