'Fat but powerful' paradox: association of muscle power and adiposity markers with all-cause mortality in older adults from the EXERNET multicentre study.

OBJECTIVES: To assess the influence of muscle power and adiposity on all-cause mortality risk and to evaluate the 'fat but powerful' (F+P) (or 'fat but fit') paradox in older adults. METHODS: A total of 2563 older adults (65‒91 years old) from the EXERNET multicentre study were included. Adiposity (body mass index (BMI), waist circumference, body fat percentage (BF%) and fat index), allometric and relative power (sit-to-stand muscle power test) and various covariates (age, sex, hypertension, smoking status and walking and sitting times per day) were registered at baseline. All-cause mortality was recorded during a median follow-up of 8.9 years. Participants were classified into four groups: lean and powerful (L+P), F+P, lean but weak and fat and weak (F+W). Cox proportional hazard regression models and adjusted HRs were calculated. RESULTS: According to BMI and waist circumference, all-cause mortality risk was reduced in the F+P (HR=0.55 and 0.63, p=0.044 and 0.049, respectively) and L+P (HR=0.57 and 0.58, p=0.043 and 0.025, respectively) groups. According to BF%, all-cause mortality decreased in the L+P group (HR=0.53; p=0.021), and a trend for a reduction was reported in the F+P group (HR=0.57; p=0.060). According to fat index, a survival benefit was only noted in the L+P group (HR=0.50; p=0.049). Higher levels of relative power reduced all-cause mortality risk among older people (HR=0.63 and 0.53, p=0.006 and 0.011, respectively). CONCLUSION: Powerful older people exhibited a reduced 9-year all-cause mortality regardless of BMI, waist circumference and BF%. Obesity according to fat index blunted the survival benefits of being powerful.

[Transabdominal oocyte retrieval: case report on an IVF cycle]. / Aspiración folicular mediante punción transabdominal: reporte de un caso en fertilización in vitro.

BACKGROUND: Ultrasound-guided transvaginal follicular aspiration is the standard of care in women undergoing oocyte retrieval during vitro fertilization (IVF). When this approach is inaccessible, there are alternative methods to extract the oocytes at the exact moment. One of these alternative options is the transabdominal ultrasound-guided follicular aspiration. We present a case report of a mixed follicular aspiration in a patient with ovaries of difficult access. CASE REPORT: A 36-year-old patient with primary infertility came for medical advice. Because of bilateral tubal occlusion, an in vitro fertilization cycle was started. Transvaginal sonograms revealed a normal left ovary, but the right one was completely attached to the anterior face of the uterus. After ovarian stimulation, transvaginal follicular aspiration was done on the left ovary, meanwhile, on the right ovary; transabdominal follicular aspiration was performed, retrieving 3 oocytes on metaphase II by this technique. Finally, there were no complications during the procedure and the patient got pregnant at the end of the treatment. CONCLUSIONS: Ultrasound-guided transabdominal follicular aspiration, is the safest and most effective technique when transvaginal access to the ovaries is compromised.

Physiological Responses during Cycling With Oval Chainrings (Q-Ring) and Circular Chainrings.

The aim of this study was to compare the physiological responses of cyclists using round (C-ring) or oval (Q-ring) chainrings during an incremental test until exhaustion. Following a randomized design, twelve male elite cyclists [age (mean ± SD): 21.1 ± 2.1 yr; VO2max: 78.1 ± 5.3 mL·kg(-1)min(-1)] performed two incremental maximal tests separated by 48 h (one with C-rings, the other with Q-rings). Starting at 100 W, the workload was increased by 25 W every 3 min until volitional exhaustion. Maximal heart rate, power output and oxygen consumption were compared. Blood lactate was monitored throughout the test. After the incremental test, 4 intermittent 20-s maximal sprints with a 60-s recovery period in between were performed. Maximal isometric voluntary contractions were performed at rest and immediately after each 20-s maximal sprint, and the force and EMG RMS amplitude were recorded from the vastus medialis and vastus lateralis muscles. For the incremental exercise test, no significant differences were found in the maximal power output (P=0.12), oxygen consumption (P=0.39), and heart rate (P=0.32) between Q-rings and C-rings. Throughout the incremental test, lactate levels were comparable when using both the C-rings and Q-rings (P=0.47). During the short sprints, power output was 2.5-6.5% greater for Q-rings than for C-rings (P=0.22). The decline in EMG RMS amplitude observed during the incremental tests was comparable for Q-rings and C-rings (0.42). These findings indicate that the oval chainring design, presented here as "Q-rings", did not significantly influence the physiological response to an incremental exercise test as compared to a conventional chainring. Key pointsDuring the incremental exercise test, no significant differences were found in power output, oxygen consumption or heart rate between oval "Q-rings" and conventional chainrings.Over the course of the incremental test, blood lactate levels were comparable for the oval "Q-rings" and conventional chainrings.During the short sprints performed after the incremental test, there were no statistical differences in power production between oval "Q-rings" and conventional chainrings.

Energy consumption, body composition and physical activity levels in 11- to 13-year-old Spanish children.

BACKGROUND/AIMS: The prevalence of overweight and obesity in childhood is increasing markedly. The aim of this study was to evaluate the relationship between physical activity, energy consumption and weight status in a cohort of Spanish children. METHODS: A total of 137 children (11-13 years old) participated in the study voluntarily (with paternal consent). Children were classified into 3 groups according to their physical activity, i.e. sedentary, active and sporty groups. Body composition measures, physical fitness and total caloric and macronutrient intake were determined. RESULTS: Weight, body mass index, waist circumference, skinfold thickness measures and body fat percentage of children were lower in the active children, whereas body water content increased with activity. Nutritional habits were similar in the 3 studied groups. No significant differences in total energy intake or percentage of carbohydrates, fat and proteins were found. All parameters related to caloric expenditure were higher in children carrying out more physical activity. CONCLUSIONS: Children with higher levels of physical activity presented more favorable anthropometric profiles, but there were no differences in respect to their dietary habits. An increase in weekly energy expenditure through physical activity outside school seems essential to prevent overweight and the risk of childhood obesity.

Comparison of heart rate and session rating of perceived exertion methods of defining exercise load in cyclists.

The aim of this study was to analyze the competition load using the session rating of perceived exertion (RPE) during different professional cycling races and to assess its validity using the competition load based on heart rate (HR). During 2 consecutive seasons, 12 professional cyclists (mean ± SEM: age 25 ± 1 years, height 175 ± 3 cm, body mass 65.9 ± 2.0 kg, and V(O2)max 78.5 ± 1.7 ml · kg(-1) · min(-1)) competed in 5-, 7-, and 21-day cycling races. The HR response and session RPE were measured during the races to calculate the competition load based on the training impulse of the HR (TRIMP(HR)) and RPE data (TRIMP(RPE)). The highest (p < 0.05) TRIMP(RPE) was observed in 21-day races. However, the higher (p < 0.05) TRIMP(HR) was found in 5- and 7-day races. When TRIMP(HR) and TRIMP(RPE) were normalized by competing distance, neither TRIMP(HR) · km(-1) nor TRIMP(RPE) · km(-1) was significantly different between the analyzed cycling races. We found significant (p < 0.001) correlations between TRIMP(HR) and TRIMP(RPE) (r = 0.75) and between TRIMP(HR) · km(-1) and TRIMP(RPE) · km(-1) (r = 0.90). In conclusion, this study showed that the session RPE can be used to quantify the competition load during professional cycling races. This method can be a useful and noninvasive tool for coaches to monitor and control the training load in cyclists.

[Fetal acardia in a twin pregnancy achieved by in vitro fertilization]. / Acardia fetal en embarazo gemelar logrado por fertilización in vitro.

The frequency of fetal arcadia in the world is 1:35,000 to 1:48,000 pregnancies; is currently estimated that 1% of newborns in developed countries are the result of assisted reproduction techniques and the frequency of twin pregnancies is close to 18%, of these, an estimated relative risk for cardiac defect is 1.6. However, the association of acardiac fetus, twin pregnancy and assisted reproductive techniques is not fully established. In this paper, we describe a case of fetal acardia, in a pregnancy resulting from assisted reproduction and its obstetric care.

[Impact of male aging in the functional capacity of sperm through the expression of phosphatidyl serine and oligonucleomas]. / Impacto del envejecimiento masculino en la capacidad funcional del espermatozoide a través de la expresión de fosfatidil serina y oligonucleomas.

BACKGROUND: biomolecular processes associated with aging and programmed cell death during spermatogenesis are well known, but not its biological significance in ejaculated sperm, because it ignores the behavior of these apoptotic markers in relation to the age of man. OBJECTIVE: To evaluate the effect of aging on the functional capacity of sperm and their relationship to programmed cell death processes. MATERIAL AND METHODS: Prospective, cross-sectional and analytical performed with semen samples from 25 healthy subjects 20 to 70 years old, were divided into two groups [(A: under 40 years) and (B: over 40 years age)]. Semen parameters were evaluated WHO (1999) and transformation processes biomolecular membrane and the expression of oligonucleosomes in the terminal cascade of apoptosis. Were measured by flow cytometry with an argon laser as a source of reading at 480 nm, the degree of cellularity discriminate negative and positive for each of the indicators. RESULTS: The percentage of live cells with phosphatidylserine translocation in the membrane (annexin-V / PI) was significantly higher in men older than 40 years (p <0.05). These findings are enriched with a significant positive correlation (r = 0.50, P <0.008) between early biomarker and age of the subjects. With regard to DNA fragmentation, although no statistically significant differences were found, it is a clear trend of increase as older the subjects (r = 0.51). CONCLUSIONS: The increasing age of the man is associated with increased expression of apoptosis, as demonstrated by the increased expression of phosphatidylserine translocation at the Membrane. Thus, this study confirms that the subject's age is associated with a decline in some of the seminal parameters.

[Effect of merocianina-540 in the fertilizing capacity of sperm correlated with the expression of 3-OH terminal fragments]. / Efecto de la merocianina-540 en la capacidad fertilizante del espermatozoide correlacionada con la expresión de fragmentos 3-OH terminales.

BACKGROUND: The packaging of heterochromatin during spermatogenesis has been correlated with the expression of residual apoptotic bodies (which stain with merocyanine A) that will impact on sperm function in the fertilization process; as well as the joint expression of the transmembrane translocation phosphatidyl serine and oligonucleosomes. OBJECTIVE: To evaluate the expression of bodies stained with merocyanine in the functional processes of sperm and their level of agreement with apoptotic Annexin V and TUNEL biomarkers. MATERIAL AND METHOD: We performed a prospective, cross, including 11,000 cells belonging to semen samples from infertile men, were evaluated according to WHO criteria (1999), bounded by the lines of Tygerberg. The biomolecular transformation processing of the membrane and the expression of oligonucleosomes in the terminal cascade of apoptosis were quantified by cytometry flow, using an argon lasser as a reading source of 480 nm, discriminating the degree of cellularity, both negative and positive for each indicators. RESULTS: Because of the study design was found low quantification in semen parameters, motility, morphology and sperm concentration. The average expression of cells [DNA-PI(+) / dUTP-FITC(+)] (quantification of TUNEL) and [Annexin-V(+) / PI(-)] was 36.5 +/- 17.4% and 31.2 +/- 17.4%, respectively. By comparing the expression of TUNEL without the effect of M540 bodies (36.3 +/- 1.7% vs. 36 +/- 1.7%) a significant difference was not determined. CONCLUSIONS: This study shows that there is a remnant of the primary processes of spermiation, which can take an important role in apoptotic and functional processes of the sperm. However, its expression does not affect measurement of biomarkers of apoptosis seminal, whose determination changed the diagnosis and functional perception of reproductive parameters in the sperm.

[Intrauterine insemination versus programmed intercourse in cycles of controlled ovaric hyperstimulation]. / Inseminación intrauterina versus coito programado en ciclos de hiperestimulación ovárica controlada.

BACKGROUND: Assisted reproduction techniques are used more and more frequently in the treatment of coulples with infertility diagnosis. OBJECTIVE: To analyze the intrauterine insemination (IUI) value in controlled ovarian hyperstimulation cycles (COH). MATERIAL AND METHODS: An analytic, comparative, retrospective and longitudinal case-control study was performed. COH with IUI (group I) or with timed intercourse (TI) (group II) cycles from January 1st 2004 to December 31st 2006 were analyzed. Infertile patients aged between 24 and 42 years (group I) and between 23 and 36 years (group II) were included. The following variables were analyzed: Age, type, etiology and duration of infertility, sperm density and motility after capacitation or seminal analysis, number of total and mature follicles, endometrial thickness, gonadotropin type and dosage, insemination or TI cycle day. Pregnant vs non pregnant and pregnancies in both groups were analyzed. Results were analyzed with the STATA 7.0 and SPSS 12.0 programs. RESULTS: 873 COH+I UI cycles in 539 couples and 246 COH+ TI in 138 patients were analyzed the pregnancy rates per cycle were 13.1% and 5.2% for each group respectively. The mean woman's age was of 32.9 +/- 3.5 and 31.8 +/- 2.7 years for groups I and II respectively. There were significant differences in sperm density in both groups. The remaining variables showed no statistical differences. CONCLUSIONS: IUI versus TI do not seems to be superior with respect to the pregnancy rates in COH cycles.

Fine and coarse particulate matter chemical characterization in a heavily industrialized city in central Mexico during Winter 2003.

This paper presents the results of the first reported study on fine particulate matter (PM) chemical composition at Salamanca, a highly industrialized urban area of Central Mexico. Samples were collected at six sites within the urban area during February and March 2003. Several trace elements, organic carbon (OC), elemental carbon (EC), and six ions were analyzed to characterize aerosols. Average concentrations of PM with aerodynamic diameter of less than 10 microm (PM10) and fine PM with aerodynamic diameter of less than 2.5 microm (PM2.5) ranged from 32.2 to 76.6 [g m(-3) and 11.1 to 23.7 microg m(-3), respectively. OC (34%), SO4= (25.1%), EC (12.9%), and geological material (12.5%) were the major components of PM2.5. For PM10 geological material (57.9%), OC (17.3%), and SO4= (9.7%) were the major components. Coarse fraction (PM,, -PM2.5), geological material (81.7%), and OC (8.6%) were the dominant species, which amounted to 90.4%. Correlation analysis showed that sulfate in PM2.5 was present as ammonium sulfate. Sulfate showed a significant spatial variation with higher concentrations to the north resulting from predominantly southwesterly winds above the surface layer and by major SO2 sources that include a power plant and refinery. At the urban site of Cruz Roja it was observed that PM2.5 mass concentrations were similar to the submicron fraction concentrations. Furthermore, the correlation between EC in PM2.5 and EC measured from an aethalometer was r(2) = 0.710. Temporal variations of SO2 and nitrogen oxide were observed during a day when the maximum concentration of PM2.5 was measured, which was associated with emissions from the nearby refinery and power plant. From cascade impactor measurements, the three measured modes of airborne particles corresponded with diameters of 0.32, 1.8, and 5.6 microm.

Estimation of the neuromuscular fatigue threshold from an incremental cycling test using 1-minute exercise periods.

BACKGROUND: The objectives of this study were: 1) to evaluate the method used for estimating the neuromuscular fatigue threshold from surface electromyographic amplitude (the PWCFT test) during a single incremental cycling workout using 1-minute exercise periods, and 2) to investigate the possible associations between PWCFT and metabolic (onset of blood lactate accumulation [OBLA]) and ventilatory (ventilatory threshold [VT] and respiratory compensation point [RCP]) variables. METHODS: Sixteen cyclists performed incremental cycle ergometer rides to exhaustion with bipolar surface sEMG signals recorded from the vastus lateralis. Subsequently, participants performed one constant-workload exercise test at 100% of their PWCFT. RESULTS: During the incremental test, the power output at PWCFT was not correlated with that of OBLA (P>0.05), but it was positively correlated with those of VT and RCP (P<0.05). During the constant-workload test, heart rate and blood lactate increased progressively and significantly (P<0.05), whereas sEMG amplitude remained unchanged (P>0.05). The average duration of the constant-workload exercise was 8-9 minutes. CONCLUSIONS: The application of the PWCFT method using 1-min exercise periods could lead to overestimation of the neuromuscular fatigue threshold most likely because this stage duration allows insufficient time for the sEMG response to manifest.

Validation of the self-report EXERNET questionnaire for measuring physical activity and sedentary behavior in elderly.

This study aims to examine the validity and reliability of the Elderly EXERNET Physical Activity Questionnaire (EEPAQ) in a sample of Spanish elderly population. A sample of 73 elderly successfully completed the EEPAQ and wore an accelerometer over 7 consecutive days. Test-retest reliability of the EEPAQ was assessed by having the participants answer the EEPAQ twice within 14 days. Criterion validity was assessed for the questionnaire against the accelerometer, as the gold standard. Results indicated that EEPAQ had adequate reliability measured by Intraclass correlation coefficient (ICC) (walking ICC=0.88; sitting ICC=0.68; household activities ICC=0.97), and good validity against the accelerometer. Walking had a significant (p<0.05) correlation with countsmin-1 (r=0.56) and moderate to vigorous physical activity (MVPA) (r=0.51), as well as a negative significant (p<0.01) correlation with sedentary minutes (r=-0.33). Sitting time was positively correlated (r=0.57; p<0.01) with sedentary time and negatively correlated with the countsmin-1 and MVPA. EEPAQ seems to be a valid and reliable tool to measure physical activity (PA) in a population of elderly living in Spain.

Increased lymphocyte antioxidant defences in response to exhaustive exercise do not prevent oxidative damage.

It has been reported that exercise induces oxidative stress and causes adaptations in antioxidant defences. The aim of this study was to determine the adaptations of lymphocytes to the oxidative stress induced by an exhaustive exercise. Nine voluntary male subjects participated in the study. The exercise was a cycling mountain stage (171.8 km), and the cyclists took a mean of 283 min to complete it. Blood samples were taken the morning of the cycling stage day, after overnight fasting, and 3 h after finishing the stage. We determined the blood glutathione redox status (GSSG/GSH), lymphocyte antioxidant enzyme activities and superoxide dismutase (SOD) levels; the plasma and lymphocyte vitamin E levels; the serum lactate dehydrogenase (LDH) and creatine kinase (CK) activities and urate levels; the plasma carotene and malonaldehyde (MDA) levels; and the lymphocyte carbonyl index. The cycling stage induced significant increases in blood-oxidized (glutathione/GSSG), plasma MDA and serum urate levels. The exercise also produced increases in CK and LDH serum activities. The mountain cycling stage induced significant increases in lymphocyte vitamin E levels, glutathione peroxidase and glutathione reductase activities as well as increased SOD activity and protein levels. The protein carbonyl levels increased significantly in lymphocytes after the stage. In conclusion, in spite of increasing antioxidant defences in response to the oxidative stress induced by the exhaustive exercise, lymphocyte oxidative damage was produced after the stage as demonstrated by the increased carbonyl index even in very well trained athletes.

[Effect of intramural and subserous myomas on in vitro fertilization cycles and their perinatal results]. / Efecto de los miomas intramurales y subserosos en los ciclos de fertilización in vitro y sus resultados perinatales.

OBJECTIVE: To evaluate the effect of intramural and subserous myomas in in vitro fertilization cycles, as well as its perinatal results. TYPE OF STUDY: Cases and controls. MATERIAL AND METHODS: All the IVF cycles between October 1999 and December 2004 were included. The variables of size and type of myomas, as well as variables of IVF cycles, implantation and pregnancy rates, and perinatal results were analyzed. We calculated the chi-square test to analyze the relationship between myomas and pregnancy. The t-Student test was used to establish the difference in the average between both groups regarding the studied variables. In the logistic regression analysis we controlled confusing variables. RESULTS: We analyzed 431 cycles made in 364 patients divided into two groups: study cases (with myomas-65 cycles) and control cases (without myomas-366 cycles). Age was two years older in the study group (35.7 vs 33.5, p < 0.001). There was no difference in: duration, type of infertility, days of stimulation, gonadotrophin dose, total and mature follicles, and fertilization and implantation rates. We only observed a difference in the recovered oocytes (8.0 vs 9.7, p = 0.027). The pregnancy, abortion and live-born children rates were of 20.0 vs 23.2, 46.1 vs 29.4, and 46.1 vs 58.8%, respectively (study and control groups; p > 0.05). Logistic regression showed that myomas do not affect the possibility of getting pregnant. CONCLUSION: Intramural and subserous myomas < 5 cm do not seem to have an effect in the IVF cycles nor in its perinatal results. In women with myomas < 5 cm that no dot distortion the uterine cavity it is questionable the usefulness of a myomectomy prior to IVF cycles.

[Prognostic factors of pregnancy in intrauterine insemination]. / Factores pronóstico de embarazo en inseminación intrauterina.

BACKGROUND: The artificial insemination is the introduction of spermatozoa in the feminine genital tract without carrying out sexual contact and with the purpose of obtaining the pregnancy. The insemination intrauterine has improved its rate of success thanks to the technological advances and the best knowledge of human reproductive physiology. OBJECTIVES: To evaluate the prognostic factors for the pregnancy success and calculate the cumulative rate per cycle in IUI (intrauterine insemination). PATIENTS AND METHODS: This study was descriptive, retrospective, analytic, and longitudinal. The cycles of IUI were analyzed from January 1st 2003 to December 31st 2005. Couples 24-41 years old with primary and secondary infertility were included. The following variables were studied: age of participant, type of infertility, length of infertility, aetiology, postcapacitation sperm density and motility, number of follicles, endometrial thickness, and the cycle number in which the IUI was performed. Patients carried out a protocol of ovarian stimulation and follicular follow up. The results were analyzed with 11.0 SPSS, continuous variables were analyzed and reported as means +/- SD with univariate logistic regression to determine statistic significance. Categoric variables were reported in frequencies and percentages. ROC curves were calculated to determine optimal cutting points. RESULTS: 668 cycles were analyzed in 391 couples. The pregnancy rate per cycle and couple was of 13.0 and 21.7% respectively. Means +/- SD patient age was 33.5 +/- 3.4 years old. The three variables with p < 0.05 were: the infertility duration, sperm motility and the cycle number in which IUI was performed. No statistical significance was found in the remaining variables. CONCLUSIONS: The greatest success in IUI will be achieved with infertility of 4 years or less, with sperm motility of 77.6% and in the first two cycles of treatment.

Influence of Exposure to Chronic Persistent Low-Dose Ionizing Radiation on the Tumor Biology of Clear-Cell Renal-Cell Carcinoma. An Immunohistochemical and Morphometric Study of Angiogenesis and Vascular Related Factors.

Increased angiogenesis is related to boosted growth and malignancy in carcinomas. "Chronic Persistent Low-Dose Ionizing Radiation" (CPLDIR) exposure increases incidence and aggressive behavior of clear-cell renal-cell carcinoma (CCRCC). The aim was to study the biology of angiogenesis, including microvessel density (MVD), in human clear-cell renal-cell carcinomas (CCRCC) originating from a radio-contaminated geographical area (Ukraine) and to compare with similar tumors diagnosed in non-contaminated regions of Europe (Spain, Valencia) and Latin America (Colombia, Barranquilla). MVD was comparatively examined in 124 patients diagnosed with CCRCC from three geographical areas by means of digital micro-imaging and computerized analysis. Additionally, 50 adult normal kidneys were used for controls (autopsy kidneys from Valencia and Barranquilla). Furthermore, an immunohistochemical study of several vascular related growth factors was undertaken using a similar methodology. MVD as well as VEFG are the most discriminating factors associated with an aggressive behavior of CCRCC. Their expression increased in proportion to the level of exposure to chronic low-dose ionizing radiation in Ukrainian patients in the 25 years since the Chernobyl accident substantiated by comparison with the two control groups of renal carcinomas present in non-irradiated areas (Spain and Colombia). No major biological differences relating to angiogenesis appear to exist between the CCRCC diagnosed in two distant geographical areas of the world. HIF-1α expression was similar in all groups, with no statistical significance. Present findings demonstrate the existence of a significant relationship between MVD and VEGF in CCRCC: an increased expression of VEGF is associated with a high level of angiogenesis.

Evaluación de la tasa de blastocistos euploides en fase folicular y lútea (DuoStim) en mujeres con pobre respuesta ovárica: estudio preliminar en México / Euploid blastocyst rate in follicular vs luteal phase (DuoStim) in women with poor ovarian response: Preliminary study in Mexico

Resumen: OBJETIVO: Comparar la tasa de blastocistos euploides obtenida después de la estimulación ovárica en fase folicular con la fase lútea en un mismo ciclo menstrual en pacientes con deficiente respuesta ovárica. MATERIALES Y MÉTODOS: Estudio clínico, prospectivo y comparativo llevado a cabo en el Centro de Reproducción Arcos, Nascere, entre los meses de enero a julio de 2019. Se incluyeron pacientes con pobre respuesta ovárica según los criterios de Bologna y con indicación de PGT-A. Las estimulaciones en fase folicular y lútea se efectuaron con antagonista de la GnRH y FSHr/LHr (2:1) a partir del día 3 del ciclo y 5 días después de la primera recuperación de los ovocitos. Para completar el proceso de maduración ovocitaria se utilizaron análogos de GnRH, se tomó una biopsia de trofoectodermo en día 5-7. RESULTADOS: Se estudiaron 20 pacientes. Al comparar la fase folicular con la lútea la tasa de fertilización fue de 79% (IC95%: 29-46) vs 55% (IC95%: 34-53), la tasa de blastocistos 42% (IC95%: 19-44) vs 45% (IC95%: 24-55) y la tasa de blastocistos euploides 100% (IC95%: 44-53) vs 70% (IC95%: 38-46), respectivamente. Solo la tasa de recuperación de ovocitos en metafase II mostró diferencias significativas entre ambas fases 40% (IC95%: 18-37) vs 59% (IC95%: 31-59), p = 0.0333 en la fase folicular y lútea, respectivamente. CONCLUSIONES: La estimulación ovárica bifásica (folicular-lútea), en el mismo ciclo menstrual (DuoStim), resultó en mayor tasa de recuperación de ovocitos en metafase II durante la fase lútea. Sin embargo, las tasas de desarrollo embrionario a día 5-6 (blastocistos) y de embriones euploides fueron similares entre ambas fases.

Abstract: OBJECTIVE: Euploid blastocyst rate comparison between ovarian stimulation in follicular vs luteal phase performed in the same menstrual cycle in patients with poor ovarian response. MATERIALS AND METHODS: Clinical, prospective and comparative study conducted at Centro de Reproducción Arcos S.C., "Nascere", during january-july, 2019. Patients with PGT-A indication and poor ovarian response according to Bologna criteria were included. Under a short GnRH-antagonist protocol, stimulations, both in follicular and luteal phase were performed using rFSH/rLH (2:1) from day 3 of the cycle and 5 days after the first oocyte retrieval. In addition, ovulation trigger with an GnRH agonist was used, finally, on day 5-6 of embryo development, trophoctoctoderm biopsy was performed. RESULTS: In this study, 20 patients were included; when comparing follicular phase vs luteal phase, we found that fertilization rate was 79% (95%CI 29-46) vs 55% (95%CI 34-53), blastocysts rate was 42% (95%CI 19-44) vs 45% (95%CI 24-55) and euploid embryo rate was 100% (95%CI 44-53) vs 70% (95%CI 38-46). Only the oocyte recovery rate in metaphase II showed significant differences between both phases 40% (IC 95% 18-37) vs 59% (IC 95% 31-59), p=0.0333. CONCLUSION: Biphasic ovarian stimulation (follicular/ luteal) in the same menstrual cycle (DuoStim) resulted in a higher metaphase II ooctye recovery rate during the luteal phase in comparison with the follicular phase. However, the rates of blastocysts and euploid blastocysts were similar between both phases.

Diagnóstico genético preimplantacional no invasivo; datos preliminares en México / Non-invasive preimplantation genetic diagnosis; preliminary data in Mexico

Resumen: OBJETIVO: Analizar las tasas de concordancia, falsos positivos y negativos entre el ADN embrionario circulante en medio de cultivo y su relación con los reportes de la biopsia de trofoectodermo. MATERIALES Y MÉTODOS: Estudio observacional, prospectivo y comparativo, llevado a cabo en el Centro de Reproducción Arcos Nascere en noviembre 2018. Criterios: de inclusión: parejas en esquema de fertilización in vitro, con diagnóstico genético preimplantacional de aneuploidias. Criterios de exclusión: pacientes con anomalías estructurales o enfermedades monogénicas. Criterio de eliminación: blastocistos con eclosión asistida. Variables de respuesta: tasa de concordancia, falsos positivos y negativos entre las biopsias de trofoectodermo y los medios de cultivo. El análisis estadístico se realizó con SPSS 25.0, con pruebas t de Student y χ2 con valor de p < 0.05 significativa. RESULTADOS: Se analizaron 20 blastocistos de 5 parejas y se obtuvieron resultados informativos de 17 (amplificación global exitosa); 70% en día 5 y 100% en día 6. La tasa general de concordancia entre las biopsias de trofoectodermo y los medios de cultivo fue de 68.7% (42.8% en día 5 y 88.8% en día 6). En cuanto a las discrepancias, solo se observaron 2 falsos negativos en los medios de cultivo vs la biopsia de trofoectodermo (14.2% en día 5 y 11.11% en día 6); hubo 3 casos de falsos positivos (la mitad en día 5 y ninguno en día 6-7). CONCLUSIONES: Con la prueba genética no invasiva de aneuploidias se alcanzaron altas tasas de concordancia, sobre todo en embriones en día 6.

Abstract: OBJECTIVE: Analyze the concordance, false positive and false negative rates between circulating free DNA of the culture media compared to the results of the trophectoderm biopsy. MATERIALS AND METHODS: Observational, prospective and comparative study, conducted at Arcos Reproduction Center S.C. Nascere in november 2018. Couples with indication of preimplantation genetic diagnosis of aneuploidies undergoing In vitro Fertilization were included; carriers of structural anomalies or monogenic diseases were excluded and blastocysts with assisted hatching were eliminated. The response variables were the concordance, false positives and false negatives rates between trophoctoctoderm biopsies and culture media. Statistical analysis was performed with SPSS 25.0, using t-Student and chi-square tests with a value of p <0.05 significant. RESULTS: Informative results were obtained in 17 of the 20 culture media (85% successful global amplification); 70% on day 5 and 100% on day 6. The general concordance rate between trophectoderm biopsies and culture media was 68.7% (42.8% on day 5 and 88.8% on day 6). Regarding discrepancies, only 2 false negatives were observed in the culture media compared to the trophectoderm biopsy (14.2% on day 5 and 11.1% on day 6). There were 3 cases false positives (42.8% on day 5 and 0% on day 6). CONCLUSIONS: High rates of concordance were reached with the non-invasive genetic aneuploidy test, mainly in embryos on day 6.

Acute phase immune response to exercise coexists with decreased neutrophil antioxidant enzyme defences.

Long-duration or damaging exercise initiates reactions that resemble the acute phase response to infection and induces neutrophil priming for oxidative activity. Our objective was to establish the status of the antioxidant defences and of the oxidative equilibrium in the neutrophils of sportsmen prior to and after intense physical exercise. Nine voluntary male professional cyclists participated in this study. The exercise was a cycling mountain stage (171 km) and the cyclists took a mean +/- SEM of 270 +/- 12 min to complete it. We determined the activities of catalase (CAT), glutathione reductase (GR), glutathione peroxidase (GPx), the levels and activity of superoxide dismutase (SOD), the concentrations of ascorbate, glutathione and glutathione disulphide (GSSG) and DNA levels in neutrophils. The cycling stage decreased enzyme activities expressed per DNA units: CAT (33%), SOD (38%), GPx (65%); increased ascorbate concentration in neutrophils and decreased the GSH/GSSG ratio and the enzyme activities expressed per DNA units. Neutrophils could contribute to plasma antioxidant defences against oxidative stress induced by exercise because they probably provide antioxidant enzymes and ascorbate.

Effect of exercise intensity and training on antioxidants and cholesterol profile in cyclists.

The aim of this work was to evaluate the effect of different intensity of exercise and different training status on antioxidants and cholesterol profile in cyclists. 33 male cyclists (17 amateur and 16 professional cyclists) participated in this study. The amateurs all trained 14 +/- 1 h each week, and their VO(2) max was 62.5 +/- 1.8 ml/Kg x min; the professionals all trained 24 +/- 1 h each week, and their VO(2) max was 80.2 +/- 1.6 ml/Kg x min. Amateurs were submitted to the maximal and submaximal prolonged exercise tests. Professionals were submitted to a mountain stage (170 km) of cycling competition. Serum lipid and cholesterol profile (triglycerides, total cholesterol, HDL-cholesterol, LDL-cholesterol and VLDL-cholesterol) and plasma antioxidant capacity (ascorbic acid, alpha-tocopherol, retinol, beta-carotene and others) were measured before and after exercise tests. Hematological determinations (number of erythrocytes, hematocrit and hemoglobin concentration) and dietary intake were also measured. No significant differences were observed in basal values (before exercise tests) of amateur and professional cyclists. Negligible differences were found between dietary intake of amateur and professional cyclists, and also the results of hematological values showed there was no effect of degree of hydration or dietary intake on blood levels of studied antioxidant and lipid parameters. An increase in plasma levels of vitamin C, vitamin E, triglycerides and VLDL-cholesterol levels, and also a decrease of beta-carotene and LDL-cholesterol. were observed in well-trained professional cyclists after the cycling stage - an endurance exercise--but not in amateur cyclists. Amateur cyclists showed only mild increases in total cholesterol after maximal and submaximal exercise, while a rise in HDL-cholesterol was only observed after maximal exercise; none of these changes were observed in professional cyclists. Plasma levels of antioxidant vitamins and carotenes, and also serum lipids, total cholesterol and lipoprotein-cholesterol showed an overall response to exercise, and their increase and/or decrease must be explained as a consequence of the different training status of sportsmen and intensity and duration of exercise tests.