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This study examined the effect of caffeine supplementation (CAFF) in a Wingate test (WT), and the behaviour of blood lactate concentrations (BLa) and neuromuscular fatigue (NMF), measured as reduced countermovement jump (CMJ) performance, in response to the WT. In a double-blind crossover study, 16 participants attended the laboratory twice, separated by a 72-hour window. In the sessions, participants first ingested 6 mg·kg-1 of either CAFF or placebo (PLAC), and then performed a WT. BLa was measured before (L-pre), and 0.5 min (L-post-0.5) and 3.5 min (L-post-3.5) after conducting the WT. The CMJ test was conducted before (CMJ pre), after (CMJ post), and 3 min after completing (CMJ post-3) the WT. The results indicated that CAFF enhanced peak power (Wpeak: + 3.22%; p = 0.040), time taken to reach Wpeak (T_Wpeak: -18.76%; p = 0.001) and mean power (Wmean: + 2.7%; p = 0.020). A higher BLa was recorded for CAFF at L-post-0.5 (+ 13.29%; p = 0.009) and L-post-3.5 (+ 10.51%; p = 0.044) compared to PLAC. CAFF improved peak power (PP; + 3.44%; p = 0.003) and mean power (MP; + 4.78%; p = 0.006) at CMJ pre, compared to PLAC, whereas PP and MP were significantly diminished at CMJ post and CMJ post-3 compared to pre (p < 0.001 for all comparisons) under both the CAFF and PLAC conditions. PP and MP were increased at post-3 compared to post (p < 0.001 for all comparisons) for both conditions. In conclusion, CAFF increased WT performance and BLa without affecting NMF measured by CMJ. Thus, CAFF may allow athletes to train with higher workloads and enhance the supercompensation effects after an adequate recovery period.
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Oxylipins play a critical role in regulating the onset and resolution phase of inflammation. Despite inflammation is a pathological hallmark in amyotrophic lateral sclerosis (ALS), the plasma oxylipin profile of ALS patients has not been assessed yet. Herein, we develop an oxylipin profile-targeted analysis of plasma from 74 ALS patients and controls. We found a significant decrease in linoleic acid-derived oxylipins in ALS patients, including 9-hydroxy-octadecadienoic acid (9-HODE) and 13-HODE. These derivatives have been reported as important regulators of inflammation on different cell systems. In addition, some 5-lipoxygenase metabolites, such as 5-hydroxy- eicosatetraenoic acid also showed a significant decrease in ALS plasma samples. Isoprostanes of the F2α family were detected only in ALS patients but not in control samples, while the hydroxylated metabolite 11-HETE significantly decreased. Despite our effort to analyze specialized pro-resolving mediators, they were not detected in plasma samples. However, we found the levels of 14-hydroxy-docosahexaenoic acid, a marker pathway of the Maresin biosynthesis, were also reduced in ALS patients, suggesting a defective activation in the resolution programs of inflammation in ALS. We further analyze oxylipin concentration levels in plasma from ALS patients to detect correlations between these metabolites and some clinical parameters. Interestingly, we found that plasmatic levels of 13-HODE and 9-HODE positively correlate with disease duration, expressed as days since onset. In summary, we developed a method to analyze "(oxy)lipidomics" in ALS human plasma and found new profiles of metabolites and novel lipid derivatives with unknown biological activities as potential footprints of disease onset.
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BACKGROUND: Psychological stress may be a risk factor for dementia, but the association between exposure to stressful life events and the development of cognitive dysfunction has not been conclusively demonstrated. We hypothesize that if a stressful event has an impact on the subjects, its effects would be different in the three diseases. OBJECTIVE: This study aims to assess the effects of stressful events in senior patients who later developed ischemic stroke, Alzheimer's, or Parkinson's disease. MATERIAL AND METHODS: Together with demographic variables (age, sex, race, socioeconomic and cultural levels), five types of past stressful events, such as death or serious illness of close relatives, job dismissal, change of financial status, retirement, and change of residence, were recorded in 1024 patients with Alzheimer's disease, Parkinson's disease, and ischemic stroke. Time-todiagnosis (months from the event to the first symptoms: retrospective study) and evolution time (years of follow-up of each patient: prospective study) were recorded. The variance and nonparametric methods were analyzed to the variables time-to-diagnosis and evolution time to analyze differences between these diseases. RESULTS: The demographic variables, such as age, sex, race, economic and cultural levels, were found to be statistically non-significant; differences in the economic level were significant (P<0.05). Significant differences (P<0.001) were found in the mean time-to-diagnosis between diseases (Alzheimer's disease>Parkinson's disease >Stroke), and minor differences (P<0.05) in evolution time. CONCLUSION: Differences in time-to-diagnosis between the diseases indicate that the stressful effect of having experienced the death or serious illness of a close relative has an impact on their emergence. The measurement of time-to-diagnosis and evolution time proves useful in detecting differences between diseases.
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Doença de Alzheimer , AVC Isquêmico , Doença de Parkinson , Idoso , Doença de Alzheimer/diagnóstico , Humanos , Acontecimentos que Mudam a Vida , Estudos Prospectivos , Estudos RetrospectivosRESUMO
Training-intensity distribution (TID) is considered the key factor to optimize performance in endurance sports. This systematic review aimed to: I) characterize the TID typically used by middle-and long-distance runners; II) compare the effect of different types of TID on endurance performance and its physiological determinants; III) determine the extent to which different TID quantification methods can calculate same TID outcomes from a given training program. The keywords and search strategy identified 20 articles in the research databases. These articles demonstrated differences in the quantification of the different training-intensity zones among quantification methods (i. e. session-rating of perceived exertion, heart rate, blood lactate, race pace, and running speed). The studies that used greater volumes of low-intensity training such as those characterized by pyramidal and polarized TID approaches, reported greater improvements in endurance performance than those which used a threshold TID. Thus, it seems that the combination of high-volume at low-intensity (≥ 70% of overall training volume) and low-volume at threshold and high-intensity interval training (≤ 30%) is necessary to optimize endurance training adaptations in middle-and long-distance runners. Moreover, monitoring training via multiple mechanisms that systematically encompasses objective and subjective TID quantification methods can help coaches/researches to make better decisions.
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Treino Aeróbico , Treinamento Intervalado de Alta Intensidade , Corrida , Treino Aeróbico/métodos , Humanos , Consumo de Oxigênio , Resistência Física/fisiologia , Corrida/fisiologiaRESUMO
Abstract Aims: To determine lactate threshold (LT) by three different methods (visual inspection, algorithmic adjustment, and Dmax) during an incremental protocol performed in the leg press 45° and to evaluate correlation and agreement among these different methods. Methods: Twenty male long-distance runners participated in this study. Firstly, participants performed the dynamic force tests in one-repetition maximum (1RM). In the next session, completed an incremental protocol consisted of progressive stages of 1 min or 20 repetitions with increments of 10, 20, 25, 30, 35, and 40% 1RM. From 40% 1RM, increments corresponding to 10% 1RM were performed until a load in which the participants could not complete the 20 repetitions. A rest interval of 2 min was observed between each stage for blood collection and adjustment of the workloads for the next stage. Results: Our results showed no significant difference in relative load (% 1RM), good correlations, and high intraclass correlation coefficients (ICC) between algorithmic adjustment and Dmax (p = 0.680, r = 0.92; ICC = 0.959), algorithmic adjustment and visual inspection (p = 0.266, r = 0.91; ICC = 0.948), and Dmax and visual inspection (p = 1.000, r = 0.88; ICC = 0.940). In addition, the Bland-Altman plot and linear regression showed agreement between algorithmic adjustment and Dmax (r2 = 0.855), algorithmic adjustment and visual inspection (r2 = 0.834), and Dmax and visual inspection (r2 = 0.781). Conclusion: The good correlation and high agreement among three methods suggest their applicability to determine LT during an incremental protocol performed in the leg press 45°. However, the best agreement found between mathematical methods suggests better accuracy.
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Humanos , Corrida , Limiar Anaeróbio , Treino Aeróbico , Algoritmos , AntropometriaRESUMO
BACKGROUND: Acute Systemic Diseases (ASD) impact on extended leukoaraiosis (ExLA) have been seldom described. We study the deterioration in daily life activities (DLA) and cognition associated with ASD events compared with the well-described impacts of stroke in patients with leukoaraiosis (L-A). METHODS: Cross-sectional surveys of aged adults from the emergency room after an acute event of ASD or stroke, hospitalized or receiving home care, were followed for one year. From 268 initial patients 206 were included in the study, all with moderate to severe L-A (Fazekas 2 and 3). The Clinical Deterioration Rating (CDR) and the modified Rankin scale with structured interview were obtained one week previous to admission and after 3 and 12 months of evolution. Comparisons were conducted within and between groups with nonparametric techniques. RESULTS: We formed three groups of similar age, A: Inpatients with one Stroke, B: Inpatients with one ASD, and C: Outpatients with one ASD. A sudden deterioration in Rankin was evident in Group A, while in B and C impairment was progressive. Impairment in CDR was smooth in all groups while in Rankin it was always greater than in cognition (CDR). No differences were found in the associations between groups and risk factors, hypertension being the most frequent one. CONCLUSION: ASD in ExL-A causes a worsening of DLA and cognition similar to that observed in ExL-A with concomitant stroke indicating the need, in ageing patients, of differential diagnosis in order to achieve the best possible treatment.
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Atividades Cotidianas , Cognição , Leucoaraiose/diagnóstico , Acidente Vascular Cerebral/diagnóstico , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Argentina/epidemiologia , Efeitos Psicossociais da Doença , Estudos Transversais , Avaliação da Deficiência , Progressão da Doença , Feminino , Humanos , Leucoaraiose/epidemiologia , Leucoaraiose/fisiopatologia , Leucoaraiose/psicologia , Imageamento por Ressonância Magnética , Masculino , Prognóstico , Estudos Prospectivos , Fatores de Risco , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/fisiopatologia , Acidente Vascular Cerebral/psicologia , Fatores de TempoRESUMO
BACKGROUND: Obesity surgery includes various gastrointestinal procedures. Roux-en-Y gastric bypass is the prototype of mixed procedures being the most practiced worldwide. A similar and novel technique has been adopted by Dr. Almino Cardoso Ramos and Dr. Manoel Galvao called "simplified bypass," which has been accepted due to the greater ease and very similar results to the conventional technique. The aim of this study is to describe the results of the simplified gastric bypass for treatment of morbid obesity in our institution. METHODS: We performed a descriptive, retrospective study of all patients undergoing simplified gastric bypass from January 2008 to July 2012 in the obesity clinic of a private hospital in Mexico City. RESULTS: A total of 90 patients diagnosed with morbid obesity underwent simplified gastric bypass. Complications occurred in 10% of patients; these were more frequent bleeding and internal hernia. Mortality in the study period was 0%. The average weight loss at 12 months was 72.7%. CONCLUSION: Simplified gastric bypass surgery is safe with good mid-term results and a loss of adequate weight in 71% of cases.
Antecedentes: la cirugía de la obesidad comprende diversos procedimientos gastrointestinales. El bypass gástrico en Y de Roux es el prototipo de los procedimientos mixtos y el más practicado en el mundo en sus diversas variedades. Una técnica similar y novedosa es la adoptada por Cardoso-Ramos y Galvao denominada "bypass simplificado" que rápidamente se aceptó por la mayor facilidad y resultados muy parecidos a la técnica convencional. Objetivo: describir los resultados a un año del bypass gástrico simplificado para el tratamiento de la obesidad mórbida. Material y métodos: estudio retrospectivo y descriptivo de todos los pacientes a quienes se realizó bypass gástrico de enero de 2008 a julio de 2012, en la clínica de obesidad de un hospital privado de la Ciudad de México. Resultados: se estudiaron 90 pacientes con diagnóstico de obesidad mórbida, con límites de edad de 18 y 65 años, operados para bypass gástrico simplificado. En 10% de los pacientes hubo complicaciones, las más frecuentes fueron: hemorragia y hernia interna. Durante el periodo de estudio la mortalidad fue de 0%. La pérdida de peso promedio a los 12 meses fue de 72.7%. Conclusión: el bypass gástrico simplificado laparoscópico es una cirugía segura, con buenos resultados a mediano plazo, y con una pérdida del exceso de peso adecuada en 71% de los casos.
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Derivação Gástrica/métodos , Laparoscopia/métodos , Adolescente , Adulto , Anastomose em-Y de Roux/métodos , Comorbidade , Feminino , Hérnia Abdominal/epidemiologia , Hérnia Abdominal/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/cirurgia , Complicações Pós-Operatórias/epidemiologia , Hemorragia Pós-Operatória/epidemiologia , Estudos Retrospectivos , Aderências Teciduais/epidemiologia , Aderências Teciduais/etiologia , Resultado do Tratamento , Veias Cavas , Trombose Venosa/epidemiologia , Trombose Venosa/etiologia , Redução de Peso , Adulto JovemRESUMO
Objetivo: Evaluar la utilidad de los métodos de diagnóstico, la efectividad de la paratiroidectomía y sus complicaciones. Sede: Hospital de Especialidades del Centro Médico Nacional Siglo XXI. Diseño: Estudio retrospectivo, descriptivo, observacional, transversal. Análisis estadístico: Medidas de tendencia central más pruebas de valor diagnóstico. Pacientes y método: Se incluyeron 21 pacientes adultos consecutivos operados por hiperparatiroidismo primario (HPTP), del 1 de enero al 31 de diciembre de 2009. Las variables analizadas fueron: edad, género, antecedentes familiares de patología paratiroidea, manifestaciones clínicas, cuantificación de niveles séricos de calcio, fósforo y hormona paratiroidea en preoperatorio y postoperatorio, depuración de creatinina y densitometría ósea; valor diagnóstico de estudios preoperatorios de localización y reporte histopatológico. Resultados: El 90% de los pacientes perteneció al sexo femenino y la edad media fue de 57 años. La nefrolitiasis, hipertensión arterial sistémica y fatiga fueron las manifestaciones clínicas y entidades asociadas con mayor frecuencia a hiperparatiroidismo primario. La ultrasonografía y la centellografía mostraron baja sensibilidad, bajo valor predictivo positivo, moderada especificidad y moderado valor predictivo negativo. El abordaje quirúrgico fue unilateral en 10 pacientes (47.5%), bilateral en 52.5%; la efectividad terapéutica fue de 85.7% en la primera intervención y 100% en la reintervención. Se registraron complicaciones en el 4.7% de los pacientes. Conclusión: En esta serie los pacientes con hiperparatiroidismo primario presentaron nefrolitiasis con mayor frecuencia; la sensibilidad diagnóstica de la ultrasonografía y centellografía en relación con la localización específica de las glándulas es inferior a lo informado. Se tuvo alta efectividad quirúrgica de la paratiroidectomía y baja frecuencia de complicaciones.
Objective: To assess the usefulness of the diagnostic methods and the efficacy of parathyroidectomy and its complications. Setting: Third level health care center (Specialty Hospital of the National Medical Center ''Siglo XXI'') Design: Retrospective, descriptive, observational, cross-sectional study. Statistical analysis: Central tendency measures and diagnostic value tests. Patients and method: The study included 21 consecutive adult patients subjected to surgery due to primary hyperparathyroidism (PHPT) from January 1st to December 31st 2009. Analyzed variables were: age, gender, familial antecedents of parathyroid pathology, clinical manifestations, pre-operative and post-operative serum levels of calcium, phosphorus, and parathyroid hormone levels, creatinine depuration, bone densitometry; diagnostic value of preoperative location study and histopathological report. Results: Ninety percent of patients were women with a mean age of 57 years. Nephrolithiasis, systemic arterial hypertension, and fatigue were the clinical manifestations most frequently associated with primary hyperparathyroidism. Ultrasonography and scintigraphy showed low sensitivity, low positive predictive value, moderate specificity, and moderate negative predictive value. Surgical approach was unilateral in 10 patients (47.5%), bilateral in 52.5%; therapeutic efficacy was of 85.7% for the first intervention, and of 100% for re-intervention. Complications were encountered in 4.7% of patients. Conclusion: In this series, patients with primary hyperparathyroidism presented nephrolithiasis more frequently, sensitivity of ultrasonography and scintigraphy in relation to specific location of glands was lower than reported. High surgical efficacy of the parathyroidectomy was achieved with low frequency of complications.