Beneficial Performance Effects of Training Load Intensification Can Be Abolished by Functional Overreaching: Lessons From a Water Polo Study in Female Athletes.

ABSTRACT: Brisola, GMP, Dutra, YM, Murias, JM, and Zagatto, AM. Beneficial performance effects of training load intensification can be abolished by functional overreaching: Lessons from a water polo study in female athletes. J Strength Cond Res 37(6): e391-e402, 2023-The purpose of this study was to compare the outcomes from 2 weeks of training load intensification strategy in female water polo players diagnosed with functional overreaching (F-OR) with no F-OR players (acute fatigue) on the performance outcomes and hormonal, immunological, and cardiac autonomic nervous system responses. Twenty-two female water polo players were allocated into control and intensification group during 7 weeks. The swimming performance, biochemical parameters, heart rate variability, profile of mood states, and upper respiratory tract infection symptoms were assessed twice before and twice after 2 weeks of intensification period. F-OR showed a worsening in total time of the repeated sprint ability (RSA) test compared with the control group and the acute fatigue group after intensification ( p ≤ 0.035). Furthermore, after the tapering period, the F-OR group maintained worse total time of the RSA test than the acute fatigue group ( p = 0.029). In addition, the acute fatigue group showed improvement in total time of the RSA test after intensification compared with the control group ( p < 0.001). No significant interactions were found for the other parameters. Therefore, periods of intensification without the F-OR development can promote higher gains in the total time of the RSA test after intensification and tapering period.

Deconstructing the Ergogenic Effects of Photobiomodulation: A Systematic Review and Meta-analysis of its Efficacy in Improving Mode-Specific Exercise Performance in Humans.

BACKGROUND: Photobiomodulation therapy (PBMT) is defined as non-thermal electromagnetic irradiation through laser or light-emitting diode sources. In recent decades, PBMT has attracted attention as a potential preconditioning method. The current meta-analysis was conducted to assess the effectiveness of PBMT in improving mode-specific exercise performance in healthy young adults. METHODS: A computerized literature search was conducted, ending on 15 May 2022. The databases searched were PubMed, Cochrane Central Register of Controlled Trials, Embase, SPORTDiscus, and the Physiotherapy Evidence Database. Inclusion/exclusion criteria limited articles to crossover, double-blind, placebo-controlled studies investigating the PBMT effects as a preconditioning method. The included trials were synthesized according to exercise mode (single-joint, cycling, running, and swimming). All results were combined using the standardized mean differences (SMDs) method and the 95% confidence intervals (CIs) were described. RESULTS: A total of 37 individual studies, employing 78 exercise performance measurements in 586 participants, were included in the analyses. In single-joint exercises, PBMT improved muscle endurance performance (SMD 0.27, 95% CI 0.12-0.41; p < 0.01) but not muscle strength performance (p = 0.92). In cycling, PBMT improved time to exhaustion performance (SMD 0.35, 95% CI 0.10-0.59; p < 0.01) but had no effect on all-out sprint performance (p = 0.96). Similarly, PBMT had no effect on time to exhaustion (p = 0.10), time-trial (p = 0.61), or repeated-sprint (p = 0.37) performance in running and no effect on time-trial performance in swimming (p = 0.81). CONCLUSION: PBMT improves muscle endurance performance in single-joint exercises and time to exhaustion performance in cycling but is not effective for muscle strength performance in single-joint exercises, running, or swimming performance metrics.

Drop jumps versus sled towing and their effects on repeated sprint ability in young basketball players.

BACKGROUND: The aim of the investigation was to compare the occurrence of post-activation performance enhancement (PAPE) after drop jumps, or heavy sled towing, and the subsequent effect on repeated sprint ability (RSA). METHODS: Ten young basketball players (17 ± 1 yrs) performed, in randomized order, RSA test with changes of direction after a standardized warm up followed by drop jumps, heavy sled towing, or no exercise (control condition). Neuromuscular assessments composed of two maximal voluntary contractions of the knee extensors, peripheral nerve stimulation, and surface electromyography (EMG), responses were recorded before and immediately after the RSA. The EMG signal of leg muscles during sprinting were also recorded as well as the blood lactate concentration. RESULTS: The drop jumps improved the RSA mean time (P = 0.033), total time (P = 0.031), and slowest time (P = 0.029) compared to control condition, while heavy sled towing did not change RSA outcomes (P > 0.05). All conditions exhibited a decrease of doublet high frequency stimulation force (pre-post measurement) (P = 0.023) and voluntary activation (P = 0.041), evidencing the occurrence from peripheral and central components of fatigue after RSA, respectively, but no difference was evident between-conditions. There was a significantly greater EMG activity during sprints for the biceps femoris after drop jumps, only when compared to control condition (P = 0.013). CONCLUSION: Repeated drop jumps were effective to induce PAPE in the form of RSA, while heavy sled towing had no effect on RSA performance in young basketball players. Furthermore, both conditioning activities exhibited similar levels of fatigue following the RSA protocol. Thus, drop jumps may be used as an alternative to induce PAPE and thus improve performance during sprints in young male basketball players.

The Effects of Regular Cold-Water Immersion Use on Training-Induced Changes in Strength and Endurance Performance: A Systematic Review with Meta-Analysis.

BACKGROUND: Cold-water immersion (CWI) is one of the main recovery methods used in sports, and is commonly utilized as a means to expedite the recovery of performance during periods of exercise training. In recent decades, there have been indications that regular CWI use is potentially harmful to resistance training adaptations, and, conversely, potentially beneficial to endurance training adaptations. The current meta-analysis was conducted to assess the effects of the regular CWI use during exercise training on resistance (i.e., strength) and endurance (i.e., aerobic exercise) performance alterations. METHODS: A computerized literature search was conducted, ending on November 25, 2019. The databases searched were MEDLINE, Cochrane Central Register of Controlled Trials, and SPORTDiscus. The selected studies investigated the effects of chronic CWI interventions associated with resistance and endurance training sessions on exercise performance improvements. The criteria for inclusion of studies were: (1) being a controlled investigation; (2) conducted with humans; (3) CWI performed at ≤ 15 °C; (4) being associated with a regular training program; and (5) having performed baseline and post-training assessments. RESULTS: Eight articles were included before the review process. A harmful effect of CWI associated with resistance training was verified for one-repetition maximum, maximum isometric strength, and strength endurance performance (overall standardized mean difference [SMD] = - 0.60; Confidence interval of 95% [CI95%] = - 0.87, - 0.33; p < 0.0001), as well as for Ballistic efforts performance (overall SMD = - 0.61; CI95% = - 1.11, - 0.11; p = 0.02). On the other hand, selected studies verified no effect of CWI associated with endurance training on time-trial (mean power), maximal aerobic power in graded exercise test performance (overall SMD = - 0.07; CI95% = - 0.54, 0.53; p = 0.71), or time-trial performance (duration) (overall SMD = 0.00; CI95% = - 0.58, 0.58; p = 1.00). CONCLUSIONS: The regular use of CWI associated with exercise programs has a deleterious effect on resistance training adaptations but does not appear to affect aerobic exercise performance. TRIAL REGISTRATION: PROSPERO CRD42018098898.

Full Body Photobiomodulation Therapy to Induce Faster Muscle Recovery in Water Polo Athletes: Preliminary Results.

Objective: To investigate the recovery of male water polo athletes applying full body photobiomodulation therapy (PBMT) regarding inflammation and muscle damage markers, testosterone and cortisol hormonal responses, heart rate variability (HRV), maximal voluntary contraction, and squat jump (SJ) after official water polo matches. Background: PBMT has been applied locally on specific muscle groups to induce faster recovery and improve the performance of athletes and nonathletes. However, many sports modalities require movement of the whole body, and a full body PBMT could be more adequate to irradiate large muscle areas homogeneously and faster. Methods: In a randomized, parallel, and double-blinded design, 13 athletes (whole team) aged 18 years attended the study and were allocated into two groups: PBMT (dose of 6.9 J/cm2, irradiance of 46.17 mW/cm2, 5 min irradiation) and placebo treatment. The study was conducted during the 2019 Brazilian under 20 water polo championship. All athletes were assessed by blood samples and neuromuscular evaluation. Immediately after each match, all athletes received PBMT (effective or placebo). Results: No significant interactions (raw values and percentage related to baseline) were observed for testosterone and cortisol, tumor necrosis factor-alpha, interleukin-6, creatine kinase concentration, maximal isometric voluntary contraction, SJ test, and HRV. Only an isolated interaction (decrease) was found for lactate dehydrogenase (LDH) response after the first match (p = 0.004, post-hoc p = 0.038). Conclusions: The parameters of the full body PBMT of this study did not induce faster recovery of inflammatory, muscle damage (excepting LDH), testosterone, cortisol, HRV, and neuromuscular responses during repeated days of water polo matches.

[Recommendations on cardiopulmonary resuscitation in patients with suspected or confirmed SARS-CoV-2 infection (COVID-19). Executive summary]. / Recomendaciones sobre reanimación cardiopulmonar en pacientes con sospecha o infección confirmada por SARS-CoV-2 (COVID-19). Resumen ejecutivo.

The SARS-CoV-2 pandemic has created new scenarios that require modifications to the usual cardiopulmonary resuscitation protocols. The current clinical guidelines on the management of cardiorespiratory arrest do not include recommendations for situations that apply to this context. Therefore, the National Cardiopulmonary Resuscitation Plan of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC), in collaboration with the Spanish Group of Pediatric and Neonatal CPR and with the Teaching Life Support in Primary Care program of the Spanish Society of Family and Community Medicine (SEMFyC), have written these recommendations, which are divided into 5 parts that address the main aspects for each healthcare setting. This article consists of an executive summary of them.

Metabolic Profile and Performance Responses During Two Consecutive Sessions of Sprint Interval Training.

Malta, ES, Brisola, GMP, de Poli, RAB, Dutra, YM, Franchini, E, and Zagatto, AM. Metabolic profile and performance responses during two consecutive sessions of sprint interval training. J Strength Cond Res 34(4): 1078-1085, 2020-The study aimed to (a) typify the cardiorespiratory, metabolic, and performance responses during a single sprint interval training (SIT) session, (b) investigate the interference of 2 subsequent sessions on cardiorespiratory, metabolic, and performance responses, and (c) verify the relationships of SIT total work performed with aerobic fitness indices. Thirty-six untrained men performed 2 SIT sessions (SIT1 and SIT2) separated by 24 hours of recovery. Each session was composed of 4 Wingate bouts interspersed by 4 minutes. Within SIT sessions, bout work, peak power, and mean power of each Wingate bout decreased significantly, while the fatigue index increased over time (p < 0.001). The SIT elicited lower acute responses of oxygen uptake and heart rate than maximal values (≈67 and ≈79%, respectively) (p < 0.05) as well as a short time spent at high cardiorespiratory demand. For SIT outcomes, no interactions were verified between Wingate bout performance, average heart rate, and average oxygen uptake. In addition, the oxygen uptake integral (SIT1:300.5 ± 38.6 ml·kg; SIT2:306.9 ± 41.1 ml·kg) and total work (SIT1:54.6 ± 10.4 kJ; SIT2:54.9 ± 10.6 kJ) did not differ between SIT sessions (p > 0.05). Furthermore, significant moderate to strong correlations were found between SIT1 and SIT2 total work and peak oxygen uptake (r = 0.48; r = 0.52, respectively), maximal aerobic power (r = 0.89; r = 0.89, respectively), and respiratory compensation point (r = 0.80; r = 0.78, respectively). In summary, an SIT session elicited a short time spent at high cardiorespiratory demand, while the SIT total work was significantly correlated with aerobic fitness indices. In addition, 2 consecutive SIT sessions interspaced by 24 hours did not affect performance outcomes, or cardiorespiratory and blood responses.

Effects of Seasonal Training Load on Performance and Illness Symptoms in Water Polo.

Brisola, GMP, Claus, GM, Dutra, YM, Malta, ES, de Poli, RAB, Esco, MR, and Zagatto, AM. Effects of seasonal training load on performance and illness symptoms in water polo. J Strength Cond Res 34(2): 406-413, 2020-The purpose of the study was to describe the training load distribution of a young female water polo team in different cycles of the season and verify its subsequent effects on specific fitness measured by the repeated sprints ability (RSA) test, aerobic endurance measured by the lactate minimum test, incidence and severity of upper respiratory tract infection (URTI) symptoms, and muscle damage markers. The training load (i.e., rating of perceived exertion × session duration) of 20 young female water polo players (mean ± SD: age = 15.65 ± 1.3 years; body mass = 60.93 ± 11.0 kg; height = 1.62 ± 0.1 m) was monitored, and the incidence and severity of URTI was assessed during part of the season. In addition, we assessed the lactate minimum speed (LMS), RSA, creatine kinase (CK), and lactate dehydrogenase (LDH) blood concentration during the season. The level of significance set was p < 0.05. The training loads were higher in the specific period (p < 0.01), whereas a high incidence of URTI was observed in the general cycle. The LMS was greater in the general cycle (p < 0.05), whereas total time and best time in the RSA test were greater in the competitive cycle (p < 0.05). The CK and LDH concentrations were significantly lower during the competitive cycle (p < 0.01). The general cycle of a female water polo team is critical regarding URTI and muscle damage, even with smaller training loads than the specific period.

Population genetic structure and Wolbachia infection in an endangered butterfly, Zizina emelina (Lepidoptera, Lycaenidae), in Japan.

Zizina emelina (de l'Orza) is listed on Japan's Red Data List as an endangered species because of loss of its principal food plant and habitat. We compared parts of the mitochondrial and nuclear genes of this species to investigate the level of genetic differentiation among the 14 extant populations. We also examined infection of the butterfly with the bacterium Wolbachia to clarify the bacterium's effects on the host population's genetic structure. Mitochondrial and nuclear DNA analyses revealed that haplotype composition differed significantly among most of the populations, and the fixation index F ST was positively correlated with geographic distance. In addition, we found three strains of Wolbachia, one of which was a male killer; these strains were prevalent in several populations. There was linkage between some host mitochondrial haplotypes and the three Wolbachia strains, although no significant differences were found in a comparison of host mitochondrial genetic diversity with nuclear genetic diversity in Wolbachia-infected or -uninfected populations. These genetic analyses and Wolbachia infection findings show that Z. emelina has little migratory activity and that little gene flow occurs among the current populations.

Drug absorption interactions between oral targeted anticancer agents and PPIs: is pH-dependent solubility the Achilles heel of targeted therapy?

A majority of the novel orally administered, molecularly targeted anticancer therapies are weak bases that exhibit pH-dependent solubility, and suppression of gastric acidity with acid-reducing agents could impair their absorption. In addition, a majority of cancer patients frequently take acid-reducing agents to alleviate symptoms of gastroesophageal reflux disease, thereby raising the potential for a common but underappreciated drug-drug interaction (DDI) that could decrease the exposure of anticancer medication and result in subsequent failure of therapy. This article is a review of the available clinical literature describing the extent of the interaction between 15 orally administered, small-molecule targeted anticancer therapies and acid-reducing agents. The currently available clinical data suggest that the magnitude of this DDI is largest for compounds whose in vitro solubility varies over the pH range 1-4. This range represents the normal physiological gastric acidity (pH ~1) and gastric acidity while on an acid-reducing agent (pH ~4).

Stress hyperglycaemia in critically ill patients: potential role of incretin hormones; a preliminary study.

BACKGROUND: Stress hyperglycaemia is common in the intensive care unit (ICU) setting and has been related to a worst outcome. OBJECTIVE: The objective was to characterize the association of glucoregulatory hormones, mainly incretins, with the levels of glycaemia, and its relationship with outcome in ICU patients. METHODS: We prospectively studied 60 patients. Stress hyperglycaemia was diagnosed when glycaemia was < 115 mg/dL. At ICU admission we determined glycaemia, insulin, glucagon, cortisol, glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) plasma levels. Groups were compared using Kruskal-Wallis test. The association between glycaemia levels and glucoregulatory hormones was evaluated using linear regression. RESULTS: Forty-five patients (75%) had hyperglycaemia. We observed no differences in glucoregulatory hormones levels between normo- and hyper- glycaemia groups. Glycaemia levels were not significantly correlated with insulin, glucagon, cortisol or GIP levels, but were correlated with GLP-1 (p = 0.04). GLP-1 was also correlated with cortisol (p = 0.01), but failed to show a significant correlation with insulin, glucagon or GIP levels. Lower levels of plasma GLP-1 were found in patients with stress hyperglycaemia requiring vasoactive support (p = 0.02). CONCLUSIONS: Glycaemia levels were correlated with GLP-1 levels in ICU patients. GLP-1 levels were also associated with cortisol. Patients with stress hyperglycaemia who required vasoactive support had lower incretin levels compared with those patients with stress hyperglycaemia who were hemodynamically stables. (ClinicalTrials.gov Identifier: NCT01087372).

Stress hyperglycaemia in critically ill patients; Potential role of incretinhormones; a preliminary study / Hiperglucemia de estrés en el paciente crítico; papel potencial de las incretinas; estudio preliminar

Background: Stress hyperglycaemia is common in the intensive care unit (ICU) setting and has been related to a worst outcome. Objective: The objective was to characterize the association of glucoregulatory hormones, mainly incretins, with the levels of glycaemia, and its relationship with outcome in ICU patients. Methods: We prospectively studied 60 patients. Stress hyperglycaemia was diagnosed when glycaemia was > 115 mg/dL. At ICU admission we determined glycaemia, insulin, glucagon, cortisol, glucose-dependent insulino -tropic polypeptide (GIP) and glucagon-like peptide-1(GLP-1) plasma levels. Groups were compared using Kruskal-Wallis test. The association between glycaemia levels and glucoregulatory hormones was evaluated using linear regression. Results: Forty-five patients (75%) had hyperglycaemia.We observed no differences in glucoregulatory hormones levels between normo- and hyper- glycaemia groups. Glycaemia levels were not significantly correlated with insulin, glucagon, cortisol or GIP levels, but were correlated withGLP-1 (p = 0.04). GLP-1 was also correlated with cortisol (p = 0.01), but failed to show a significant correlation withinsulin, glucagon or GIP levels. Lower levels of plasmaGLP-1 were found in patients with stress hyperglycaemia requiring vasoactive support (p = 0.02).Conclusions: Glycaemia levels were correlated withGLP-1 levels in ICU patients. GLP-1 levels were also associated with cortisol. Patients with stress hyperglycaemia who required vasoactive support had lower incretin levels compared with those patients with stress hyperglycaemia who were hemodynamically stables.(ClinicalTrials.gov Identifier: NCT01087372) (AU)

Antecedentes: La hiperglucemia de estrés es habitual en el contexto de la Unidad de cuidados intensivos (UCI) y se ha relacionado con un peor pronóstico. Objetivo: el objetivo fue caracterizar la asociación de hormonas glucorreguladoras, principalmente las incretinas, con las glucemias y su relación con el pronóstico de los pacientes de UCI. Métodos: Estudiamos de forma prospectiva a 60pacientes. La hiperglucemia de estrés se diagnosticaba cuando la glucemia era > 115 mg/dl. En el ingreso en la UCI, determinamos la glucemia y las concentraciones plasmáticas de insulina, glucagón, cortisol, polipéptidoinsulinotropo dependiente de glucosa (GIP) y péptido-1de tipo glucagón (GLP-1). Se compararon los grupos mediante la prueba de Kruskal-Wallis. La asociación entre las glucemias y las hormonas contrarreguladoras se evaluó mediante regresión linear. Resultados: 45 pacientes (75%) tenían hiperglucemia.No observamos diferencias en las concentraciones de hormonas glucorreguladoras entre los grupos de normo ehiperglucemia. Las glucemias no se correlacionaron de forma significativa con las concentraciones de insulina,glucagón, cortisol o GIP, pero sí con el GLP-1 (p = 0,04).El GLP-1 también se correlacionó con el cortisol (p =0,01), pero no consiguió mostrar una correlación significativa con las concentraciones de insulina, glucagón o GIP. Se encontraron menores concentraciones plasmáticas de GLP-1 en los pacientes con hiperglucemia de estrés que requerían soporte vasoactivo (p = 0,02). Conclusiones: las glucemias se correlacionaron con las concentraciones de GLP-1 en los pacientes en UCI . Las concentraciones de GLP-1 también se asociaron con el cortisol. Los pacientes con hiperglucemia de estrés que necesitaron soporte vasoactivo tenían menores concentraciones de incretina en comparación con aquellos con hiperglucemia de estrés con estabilidad hemodinámica(ClinicalTrials.gov Identifier: NCT01087372) (AU)

Evaluación de la calidad en el laboratorio en la fase preanalítica: un estudio multicéntrico / Quality assessment for preanalytical phase in clinical laboratory: a multicentric study

Introducción. El objetivo del trabajo es mostrar y analizar los resultados de errores preanalíticos en las muestras de laboratorio remitidas desde atención primaria a 7 laboratorios de la Comunidad Valenciana que atienden a 7 departamentos de salud. Material y métodos. Se realizó un estudio transversal mediante la evaluación y el análisis de los errores preanalíticos de 7 laboratorios. El error preanalítico se definió como muestra que no puede ser analizada por no cumplir los criterios de aceptabilidad o que no se recibe en el laboratorio. Se diseñaron indicadores de proporción que cuantifican cada incidencia respecto al total de cada muestra (hematología, coagulación, bioquímica y orina). Los errores preanalíticos y las muestras se recogieron automáticamente del Sistema de Información del Laboratorio, y también se calcularon los indicadores a tiempo real mediante un software basado en data warehouse y cubos OLAP. Resultados. La variabilidad de los resultados entre los diferentes centros fue elevada, evidenciándose que el mayor porcentaje de incidencias se debió a la falta de disponibilidad de las muestras, en especial de coagulación y de orina. Conclusiones. Existe una gran variabilidad de errores preanalíticos dependiendo del Departamento de Salud. Existe una necesidad de homogeneizar la práctica de la extracción de muestras(AU)

Purpose. To show the number of preanalytical sample errors in seven laboratories attending seven health departments of Valencian Community (Spain). Methods. Cross-sectional study of the number of preanlytical errors in samples obtained in primary care centers. An error is defined as a rejected specimen: any blood or urine sample, which cannot be successfully tested as it does not meet the acceptability criteria of the laboratory or if the sample is not received. We collected preanalytical errors from the tests requested for hematology, coagulation, chemistry, and urine samples. Registers were collected and indicators calculated automatically through a data warehouse and OLAP cubes software. Results. Larges differences in the results of preanalytical errors were observed between health departments. The highest percentage of errors occurred in coagulation samples, followed by urine, hematology and biochemistry. With regard to the type of error, the largest proportion of errors was due to failures of process. Conclusions. The high incidence of preanalytical errors and variability between health departments suggests that there is a need to standardize the drawing practice(AU)

[Quality assessment for preanalytical phase in clinical laboratory: a multicentric study]. / Evaluación de la calidad en el laboratorio en la fase preanalítica: un estudio multicéntrico.

PURPOSE: To show the number of preanalytical sample errors in seven laboratories attending seven health departments of Valencian Community (Spain). METHODS: Cross-sectional study of the number of preanlytical errors in samples obtained in primary care centers. An error is defined as a rejected specimen: any blood or urine sample, which cannot be successfully tested as it does not meet the acceptability criteria of the laboratory or if the sample is not received. We collected preanalytical errors from the tests requested for hematology, coagulation, chemistry, and urine samples. Registers were collected and indicators calculated automatically through a data warehouse and OLAP cubes software. RESULTS: Large differences in the results of preanalytical errors were observed between health departments. The highest percentage of errors occurred in coagulation samples, followed by urine, hematology and biochemistry. With regard to the type of error, the largest proportion of errors was due to failures of process. CONCLUSIONS: The high incidence of preanalytical errors and variability between health departments suggests that there is a need to standardize the drawing practice.

Estudio piloto regional en la Comunidad Valenciana. Indicadores financieros del laboratorio clínico / No disponible

El objetivo del trabajo es proponer un sistema de indicadores de gestión a partir de los datos normalizados del Sistema de Información conómico ( SIE) de la Agencia Valenciana de Salud que aplica a los laboratorios públicos de la Comunidad Valenciana. Como resultados se obtienen indicadores de costes, de complejidad, de rendimiento de personal y de rendimiento de material y se establece una comparación con los datos del SIE 2008 de los 9 laboratorios participantes. En conclusión, la obtención de los indicadores de gestión a partir del Sistema de Información Económico, no supone ningún trabajo adicional para el laboratorio; la información es homogénea y la comparación interlaboratorios proporciona una información de gran utilidad para la gestión de los laboratorios (AU)

No disponible

Estudio piloto regional de evaluación del tiempo de respuesta de laboratorio según el tipo de cliente / Regional pilot study to evaluate the laboratory turnaround time according to the client source

Objetivo. Presentar los resultados del tiempo de respuesta relacionado con el tipo de cliente en ocho laboratorios clínicos de la Comunidad Valenciana que atienden a ocho departamentos de salud (2.014.475 habitantes). Material y métodos. Se utilizaron registros internos (fecha/hora de registro y validación de la prueba) y registros diarios (tipo de paciente) del Sistema Informático del Laboratorio para construir los indicadores. Estos indicadores muestran el porcentaje de pruebas clave (hemograma y glucosa y tirotropina séricas) solicitadas que son validadas en el mismo día de la extracción de muestra (pacientes ingresados o de atención primaria) y/o antes de las 12.00 a.m. (pacientes ingresados). El tiempo de respuesta de pruebas urgentes se refirió a pruebas clave (troponina y potasio séricos) y se expresó en minutos. La recogida de registros y el cálculo de indicadores se realizó de forma automática mediante una aplicación informática basada en data warehouse y cubos OLAP. Resultados. Se observaron grandes diferencias en los porcentajes de validación antes de las 12.00 a.m. para pacientes ingresados y en el día de la extracción para pacientes de atención primaria. La variabilidad observada en los tiempos de respuesta de pruebas urgentes se relacionó con el tamaño del hospital, actividad y validación por el facultativo del laboratorio. Conclusiones. El estudio de benchmarking ha servido para mostrar la gran disparidad de tiempos de respuesta en ocho departamentos de salud de la Comunidad Valenciana. La atención en el laboratorio a distintos tipos de clientes crea la necesidad de la continua adaptación de los procesos para conseguir su satisfacción(AU)

Purpose. To show turnaround time to client source in eight laboratories covering eight Health Areas (2,014,475 inhabitants) of the Valencian Community (Spain). Material and methods. Internal Laboratory Information System (LIS) registers (test register and verification date and time), and daily LIS registers were used to design the indicators, These indicators showed the percentage of key tests requested (full blood count and serum glucose and thyrotropin) that were validated on the same day the blood was taken (inpatients and Primary Care and/or at 12 a.m. (inpatients). Urgent (stat) tests were also registered as key tests (serum troponin and potassium) and were recorded in minutes. Registers were collected and indicators calculated automatically through a Data Warehouse application and OLAP cube software. Results. Long turnaround time differences were observed at 12 a.m. in inpatients, and in the day of sample extraction in primary care patients. The variability in turnaround of stat tests is related to hospital size, activity and validation by the laboratory physician. Conclusions. The study results show the large turnaround time disparity in eight Health Care Areas of Valencian Community. The various requesting sources covered by the laboratories create the need for continuous mapping processes redesign and benchmarking studies to achieve customer satisfaction(AU)

[Regional pilot study to evaluate the laboratory turnaround time according to the client source]. / Estudio piloto regional de evaluación del tiempo de respuesta de laboratorio según el tipo de cliente.

PURPOSE: To show turnaround time to client source in eight laboratories covering eight Health Areas (2,014,475 inhabitants) of the Valencian Community (Spain). MATERIAL AND METHODS: Internal Laboratory Information System (LIS) registers (test register and verification date and time), and daily LIS registers were used to design the indicators, These indicators showed the percentage of key tests requested (full blood count and serum glucose and thyrotropin) that were validated on the same day the blood was taken (inpatients and Primary Care and/or at 12 a.m. (inpatients). Urgent (stat) tests were also registered as key tests (serum troponin and potassium) and were recorded in minutes. Registers were collected and indicators calculated automatically through a Data Warehouse application and OLAP cube software. RESULTS: Long turnaround time differences were observed at 12 a.m. in inpatients, and in the day of sample extraction in primary care patients. The variability in turnaround of stat tests is related to hospital size, activity and validation by the laboratory physician. CONCLUSIONS: The study results show the large turnaround time disparity in eight Health Care Areas of Valencian Community. The various requesting sources covered by the laboratories create the need for continuous mapping processes redesign and benchmarking studies to achieve customer satisfaction.

Monounsaturated and omega-3 but not omega-6 polyunsaturated fatty acids improve hepatic fibrosis in hypercholesterolemic rabbits.

OBJECTIVE: Although the influence of saturated fatty acids, monounsaturated fatty acids (MUFAs), polyunsaturated fatty acids (PUFAs), lipids, cholesterol levels, and other blood lipids has been established, few studies have examined the influence of these dietary lipids on the composition and histologic damage of organs in situations of hypercholesterolemia. Biliary lipids come from the liver, and this organ is essential in cholesterol homeostasis; thus, it may be helpful to evaluate the inter-relations among biliary, hepatic lipids, and hepatotoxic effects in situations of hypercholesterolemia with different dietary lipids. This study investigated whether administration of diets differing in fatty acid profiles (omega-3 PUFA, omega-6 PUFA, or MUFA) influence the content of biliary lipids, the lithogenic index of gallbladder bile, and the development of hepatic fibrosis in hypercholesterolemic rabbits. METHODS: Thirty rabbits were randomized to one of five groups. A control group received rabbit chow for 80 d. The remaining four groups received a 50-d diet that contained 3% lard and 13% cholesterol to provoke hypercholesterolemia. After this period, three groups were fed for another 30 d on a diet enriched with omega-6 PUFAs, MUFAs, and omega-3 PUFAs, respectively. Liver, bile, and plasma lipid compositions, lipid peroxidation in hepatic mitochondria, and histologic hepatic lesions were analyzed. RESULTS AND CONCLUSIONS: There was a beneficial effect of MUFA and omega-3 PUFA on hepatic fibrosis in hypercholesterolemic rabbits because both dietary fats led to recovery from hepatic lesions. However, because intake of omega-3 PUFA provoked lithogenic bile in rabbits, MUFA intake would be more advisable.

Mechanism of exocrine pancreatic insufficiency in streptozotocin-induced diabetes mellitus in rat: effect of cholecystokinin-octapeptide.

This study investigated the effects of cholecystokinin-octapeptide (CCK-8) on pancreatic juice flow and its contents, and on cytosolic calcium (Ca2+) and magnesium (Mg2+) levels in streptozotocin (STZ)-induced diabetic rats compared to healthy age-matched controls. Animals were rendered diabetic by a single injection of STZ (60 mg kg(-1), I.P.). Age-matched control rats obtained an equivalent volume of citrate buffer. Seven weeks later, animals were either anaesthetised (1 g kg(-1) urethane; IP) for the measurement of pancreatic juice flow or humanely killed and the pancreas isolated for the measurements of cytosolic Ca2+ and Mg2+ levels. Non-fasting blood glucose levels in control and diabetic rats were 92.40 +/- 2.42 mg dl(-1) (n = 44) and >500 mg dl(-1) (n = 27), respectively. Resting (basal) pancreatic juice flow in control and diabetic anaesthetised rats was 0.56 +/- 0.05 ul min(-1) (n = 10) and 1.28 +/- 0.16 ul min(-1) (n = 8). CCK-8 infusion resulted in a significant (p < 0.05) increase in pancreatic juice flow in control animals compared to a much larger increase in diabetic rats. In contrast, CCK-8 evoked significant (p < 0.05) increases in protein output and amylase secretion in control rats compared to much reduced responses in diabetic animals. Basal [Ca2+]i in control and diabetic fura-2-loaded acinar cells was 109.40 +/- 15.41 nM (n = 15) and 130.62 +/- 17.66 nM (n = 8), respectively. CCK-8 (10(-8)M) induced a peak response of 436.55 +/- 36.54 nM (n = 15) and 409.31 +/- 34.64 nM (n = 8) in control and diabetic cells, respectively. Basal [Mg2+]i in control and diabetic magfura-2-loaded acinar cells was 0.96 +/- 0.06 nM (n = 18) and 0.86 +/- 0.04 nM (n = 10). In the presence of CCK-8 (10(-8)) [Mg2+]i in control and diabetic cells was 0.80 +/- 0.05 nM (n = 18) and 0.60 +/- 0.02 nM (n = 10), respectively. The results indicate that diabetes-induced pancreatic insufficiency may be associated with derangements in cellular Ca2+ and Mg2+ homeostasis.

Effect of insulin on exocrine pancreatic secretion in healthy and diabetic anaesthetised rats.

This investigation characterised the effects of exogenous insulin on exocrine pancreatic secretion in anaesthetised healthy and diabetic rats. Animals were rendered diabetic by a single injection of streptozotocin (STZ, 60 mg kg(-1) I.P.). Age-matched controls were injected citrate buffer. Rats were tested for hyperglycaemia 4 days after STZ injection and 7-8 weeks later when they were used for the experiments. Following anaesthesia (1 g kg(-1) urethane I.P.), laparotomy was performed and the pancreatic duct cannulated for collection of pure pancreatic juice. Basal pancreatic juice flow rate in diabetic rats was significantly (p < 0.001) increased whereas protein and amylase outputs were significantly (p < 0.001) decreased compared to control rats. Insulin (1 IU, I.P.) produced in healthy rats significant increases in pancreatic flow rate, amylase secretion and protein output compared to basal (p < 0.05). Insulin action also included a reduction in blood glucose (152.7 +/- 16.9 mg dl(-1), n = 6, prior to insulin and 42.0 +/- 8.4 mg dl(-1), n = 4, 100 min later). In fact, flow rate and glycaemia showed a strong negative correlation (p < 0.01, Pearson). Pretreatment with atropine (0.2 mg kg(-1), I.V.) abolished the effects of insulin on secretory parameters despite a similar reduction in glycaemia; in this series of experiments the correlation between flow rate and blood glucose was lost. In diabetic rats, insulin (4 IU, I.P.) did not modify exocrine pancreatic secretion. There was a fall in blood glucose (467.6 +/- 14.0 mg dl(-1), n = 10, prior to insulin and 386.6 +/- 43.6 mg dl(-1), n = 7, 120 min later). Rats, however, did not become hypoglycaemic. Similar results were observed in diabetic atropinized rats. The results of this study indicate that the effects of insulin on exocrine pancreatic secretion in anaesthetised healthy rats are mediated by hypoglycaemia-evoked vagal cholinergic activation.