Cadaveric Adipose-Derived Stem Cells for Regenerative Medicine and Research.

Advances in regenerative medicine have enabled the search for new solutions to current health problems in so far unexplored fields. Thus, we focused on cadaveric subcutaneous fat as a promising source of adipose-derived stem cells (ADSCs) that have potential to differentiate into different cell lines. With this aim, we isolated and characterized ADSCs from cadaveric samples with a postmortem interval ranging from 30 to 55 h and evaluated their ability to differentiate into chondrocytes or osteocytes. A commercial ADSC line was used as reference. Morphological and protein expression analyses were used to confirm the final stage of differentiation. Eight out of fourteen samples from patients were suitable to complete the whole protocol. Cadaveric ADSCs exhibited features of stem cells based upon several markers: CD29 (84.49 ± 14.07%), CD105 (94.38 ± 2.09%), and CD44 (99.77 ± 0.32%). The multiparametric assessment of differentiation confirmed the generation of stable lines of chondrocytes and osteocytes. In conclusion, we provide evidence supporting the feasibility of obtaining viable postmortem human subcutaneous fat ADSCs with potential application in tissue engineering and research fields.

Body surface area is a predictor of maturity status in school children and adolescents.

BACKGROUND: Generally, Body surface area (BSA) changes significantly during growth and maturation. These increases portend a possible relationship between body size as determined by BSA with maturational status in children and adolescents. OBJECTIVE: To determine the relationship between maturity status (MS) obtained by non-invasive anthropometric methods and body surface area (BSA) in children and adolescents of both sexes in a regional population of Chile. Additionally, we sought to verify the type of linear or nonlinear relationship between MS and BSA in both sexes. METHODS: A descriptive (cross-sectional) study was designed in 950 children and adolescents of both sexes (539 males and 411 females). The age range ranged from 6.0 to 17.9 years. Anthropometric measurements were evaluated: body weight, standing height, sitting height. MS was assessed by means of two non-invasive anthropometric techniques. Both techniques predict peak years of growth velocity (APHV) through a regression equation for each sex. BSA (m2) was estimated by means of the Haycock equation. RESULTS: The R2 in the linear model is relatively lower (R2 = 0.80 to 0.89 in males and 0.74 to 0.66 in females) in relation to the nonlinear quadratic model (R2 = 0.81 in males and 0.76 to 0.69). The quadratic nonlinear quadratic model reflected an adequate fit (RMSE) for the data set, being in men (RMSE = 1.080 and 1.125), while in women (RMSE = 1.779 and 1.479). CONCLUSION: BSA is positively associated with MS determined by two non-invasive methods in Chilean children and adolescents: The nonlinear quadratic model was a better fit to the data distribution. The results suggest the use of BSA as a possible predictor of maturity status in Chilean youth.

Assessing quality of life with SarQol is useful in screening for sarcopenia and sarcopenic obesity in older women.

BACKGROUND: Health-related quality of life (HRQoL) may be impaired in the presence of sarcopenia. Since a specific quality of life questionnaire became available for sarcopenia (SarQol), cutoffs to screen for this condition have been proposed, prompting the need to assess them in different populations. Due to the lack of consensus on diagnostic criteria, the tool has not yet been analyzed in screening for sarcopenic obesity. AIM: Our aim is to measure the SarQoL's metric properties and establish a cutoff in QoL assessments that could be used along the diagnostic pathway for sarcopenia and sarcopenic obesity in community-dwelling older women. METHODS: This cross-sectional study assessed women aged ≥ 70 years using the SarQol, sarcopenia criteria (EWGSOP2) and sarcopenic obesity criteria (ESPEN/EASO). Cutoffs for the SarQol were defined with a receiver-operating characteristics (ROC) curve, and sensitivity and specificity were analyzed. RESULTS: Of the 95 included women (mean age 76.0 years, standard deviation [SD] 5.7), 7.3% (n = 7) were classified as having sarcopenic obesity, 22.1% (n = 21) as having sarcopenia, and 70.5% (n = 67) as not having sarcopenia. The total SarQol score was higher in women without sarcopenia (66.5 SD 16.2) versus those with sarcopenia (56.6 SD 15.6) and sarcopenic obesity (45.1 SD 7.9). A cutoff of ≤ 60 points is proposed for sarcopenia screening (area under the ROC curve [AUC] 0.67; 95% confidence interval [CI] 0.53-0.80; sensitivity 61.9%; specificity 62%), and ≤ 50 points for sarcopenic obesity (AUC 0.85; 95% CI 0.74-0.95; sensitivity 71.4%; specificity 76.9%). CONCLUSIONS: Quality of life is compromised in women with sarcopenia and especially in those with sarcopenic obesity. The SarQol could be useful in screening for these conditions, providing insight into health-related quality of life in older people with sarcopenia.

Evolución epidemiológica y causas de muerte súbita en lactantes: estudio poblacional desde 1991 a 2020 en Bizkaia / Epidemiological changes and causes of sudden unexpected death in infancy: A 30-year population-based study in Basque Country

Introducción: la muerte súbita del lactante (MSL) representa un grave problema de salud pública. El objetivo del trabajo es analizar sus características epidemiológicas y clínico-patológicas. Método: estudio retrospectivo poblacional de la MSL en Bizkaia entre 1991–2020. Se examinaron datos del Registro de Mortalidad y Servicio de Patología Forense. Resultados: se registraron 1.109 defunciones en menores de un año. En 107 se efectuó autopsia forense: 61 síndromes de muerte súbita del lactante (SMSL) y 23 MSL de causa explicada. En otros 10 casos se codificó el SMSL como causa de muerte sin autopsia forense. La incidencia del SMSL fue de 0,26/1.000 recién nacidos/año y descendió desde 0,74 (quinquenio 1991–1995) a 0,07 (quinquenios 2011–2020). El porcentaje del SMSL en relación a la mortalidad total decreció del 11,2 al 2,5%. En el SMSL predominó la categoría IB de San Diego (67%) y los lactantes entre 1–4 meses (63%). Un «ambiente de sueño inseguro» se detectó en 6 SMSL. El 56,5% de las MSL explicadas fueron infecciosas. De los 84 casos de MSL autopsiados, el 70% no tenía enfermedades previas y el 15% eran prematuros y/o recién nacidos de bajo peso. En el 32% existieron síntomas prodrómicos, principalmente infección de vías respiratorias. Hallazgos microscópicos sugestivos de infección respiratoria se diagnosticaron en 10 SMSL. Conclusiones: la incidencia del SMSL en Bizkaia es baja y ha disminuido notablemente en los últimos 30 años. La sintomatología prodrómica y los signos histopatológicos sugestivos de infección son relativamente frecuentes. En el futuro serían deseables investigaciones prospectivas multidisciplinares y multicéntricas.(AU)

Introduction: Sudden unexpected deaths in infancy (SUDI) represents a serious public health problem. The objective of this work is to analyze its epidemiological and clinical-pathological characteristics. Method: Retrospective population study of SUDI in Bizkaia between 1991–2020. Data from the Mortality Registry and Forensic Pathology Service were examined. Results: 1,109 deaths in children under one year were recorded. A forensic autopsy was performed in 107: 61 cases of sudden infant death syndrome (SIDS) and 23 SUDI of explained cause. In other 10 cases SIDS was coded as cause of death without forensic autopsy. The incidence of SIDS was 0.26/1000/year and decreased from 0.74 (1991–1995 five-year period) to 0.07 (2011–15 and 2016–20 periods). The percentage of SIDS in relation to total mortality decreased from 11.2 to 2.5%. In SIDS, category IB from San Diego (67%) and infants between 1 and 4 months (63%) predominated. An “unsafe sleep environment” was detected in 6 SIDS. 56.5% of the explained SUDI were infectious. Of the 84 autopsied SUDI cases, 70% had no pre-existing disease and 15% were premature and/or low birth weight infants. In 32% there were prodromal symptoms, mainly respiratory tract infection. Microscopic findings suggestive of respiratory infection were diagnosed in 10 SIDS. Conclusions: The incidence of SIDS in Bizkaia is low and has decreased notably in the last 30 years. Prodromal symptoms and histopathological signs suggestive of infection are relatively common. Forensic studies provide relevant data, although prospective multidisciplinary and multicenter research would be desirable.(AU)

Resistance training of peripheral muscles benefits respiratory parameters in older women with sarcopenia: Randomized controlled trial.

PURPOSE OF THE RESEARCH: Ageing entails a decrease in muscle mass and strength, known as sarcopenia, which also affects respiratory function. Physical exercise is an appropriate intervention to treat both conditions. This study aims to assess the efficacy of high-intensity resistance training (HIRT) on clinical parameters of respiratory function and health-related quality of life (QoL) in community-dwelling older women with sarcopenia. METHODS: Fifty-one sarcopenic community-dwelling women aged 70 years and older were randomized to either six months of HIRT (n = 24) or control (n = 27). At baseline and post-intervention, participants were assessed for skeletal-muscle sarcopenia; respiratory sarcopenia status; respiratory function: spirometry (FEV1, FVC, FEV1/FVC, and FEF25-75) and expiratory (MEP) and inspiratory (MIP) respiratory muscle strength parameters; and health-related QoL (EURO-QOL 5D-3 L). RESULTS: A group-by-time interaction effect for MEP (p = 0.044, È 2=0.108) was observed. CG showed a significant decrease in FEV1 (mean difference [MD] -0.12 L; 95% confidence interval [CI] -0.20, -0.05; p = 0.002); and FVC (MD -0.18 L; 95% CI -0.33, -0.03; p = 0.024) after six months, whereas the HIRT maintained respiratory function without change. Post-intervention, mean EQ-VAS increased in the HIRT and decreased in CG, resulting in a significant between-group difference (mean 73.0 standard deviation [SD] 16.99 vs 61.1 SD 18.2 points, respectively; p = 0.044). Respiratory sarcopenia status was reverted in the HIRT. CONCLUSIONS: HIRT increased muscle strength and halted age-related respiratory function decline in sarcopenic old women. A strength intervention could benefit health-related QoL and physical well-being. REGISTERED IN CLINICALTRIALS.GOV: NCT03834558.

Fat infiltration and muscle hydration improve after high-intensity resistance training in women with sarcopenia. A randomized clinical trial.

BACKGROUND: Resistance training is recommended for preventing sarcopenia, but the benefits for the quality and quantity of muscle mass are uncertain. OBJECTIVE: To assess the effects of high-intensity resistance training (HIRT) on clinical and magnetic resonance imaging (MRI) parameters in women with sarcopenia. METHODS: A researcher-blinded randomized clinical trial was conducted. Community-dwelling older women with sarcopenia were randomized to six months of HIRT or a control group (CG). Body composition was assessed with bioimpedance equipment, and participants underwent strength and functional performance tests (short physical performance battery [SPPB] and gait speed). MRI scans of the thigh were taken to quantify muscle mass and quality. RESULTS: Thirty-eight women completed the study (20 in the HIRT group). Sarcopenia remitted in 50 % of the HIRT group. HIRT elicited a significant group × time interaction effect for muscle mass (p = 0.027; È 2 = 0.129), muscle mass index (p = 0.023; È 2 = 0.135), fat mass (p = 0.048; È 2 = 0.103) and all strength variables (p < 0.05; È 2 > 0.120). Moreover, the HIRT group obtained higher scores on the SPPB (mean difference [MD] 1.2; p = 0.005) and the 5 times sit-to-stand test (MD = 0.7; p = 0.009). Regarding MRI parameters, infiltrated microscopic fat decreased significantly (HIRT: MD = -0.01; p < 0.05), while hydration (T2) decreased in the CG (MD = 3.6 ms; p = 0.053) at six months. There were significant between-group differences at six months for water diffusion (HIRT: 1.09 × 10-3 mm2/s vs CG: 1.26 × 10-3 mm2/s) and total muscular volume (HIRT: 832.4 L vs CG: 649.2 L). CONCLUSIONS: HIRT led to the remission of sarcopenia in half of the older women, as seen in muscle mass, strength, and functional performance and MRI biomarkers, with significant increases in muscle quality. REGISTERED IN CLINICALTRIALS.GOV: NCT03834558.

Potential Development of Vitrified Immature Human Oocytes: Influence of the Culture Medium and the Timing of Vitrification.

How does the in vitro maturation (IVM) medium and the vitrification procedure affect the survival of germinal vesicle (GV) oocytes obtained from stimulated cycles and their development to the blastocyst stage? In total, 1085 GV human oocytes were obtained after women underwent a cycle of controlled ovarian stimulation, and these oocytes were subjected to IVM before or after their vitrification. IVM was carried out in two commercial culture media not specifically designed for maturation. MII oocytes were then activated and embryo development until day 6 was evaluated. According to the results, a higher percentage of oocytes reach the MII stage if they are vitrified before they undergo IVM. Nevertheless, the medium used and the sample size determine whether these differences become significant or not. Similar survival rates and development to blastocysts were observed in all the conditions studied.

Muerte súbita relacionada con la actividad deportiva en España. Estudio poblacional multicéntrico forense de 288 casos / Sports-related sudden cardiac death in Spain. A multicenter, population-based, forensic study of 288 cases

Introducción y objetivos Conocer la incidencia, características clínico-patológicas, hábitos tóxicos y actividad deportiva relacionadas con la muerte súbita en la actividad deportiva en España.MétodosEstudio poblacional retrospectivo y multicéntrico, basado en autopsias forenses realizadas en 25 provincias durante 8 años (2010-2017).ResultadosSe investigaron 288 casos (el 98,6% varones; media de edad, 43,8±14,4 años). La incidencia fue de 0,38 casos/100.000 hab./año (0,82 entre deportistas habituales), la mayoría (54%) varones entre 35 y 54 años. Los deportes más frecuentes (el 96% recreativos) fueron ciclismo (28%), fútbol (18%) y carrera a pie (17%). La muerte fue de origen cardiovascular en el 99%: cardiopatía isquémica (63%), miocardiopatías (21%) y síndrome de muerte súbita arrítmica (6%). En los jóvenes, las miocardiopatías (38%) y la cardiopatía isquémica (30%), presente a partir de los 20 años, fueron las más prevalentes. La enfermedad se había diagnosticado en vida en 23 casos; se observaron antecedentes clínicos relevantes en 30 casos y factores de riesgo cardiovascular, principalmente obesidad, en 95. El análisis toxicológico detectó sustancias cardiotóxicas en el 7%, y destaca la relación entre cannabis y cardiopatía isquémica aguda.ConclusionesLa muerte súbita asociada a la actividad deportiva en España tiene una incidencia muy baja, afecta a varones de mediana edad que realizan deporte recreativo, principalmente ciclismo, fútbol y carrera, y es de origen cardiovascular, con aparición temprana de la cardiopatía isquémica. Los datos clínicos y los hábitos tóxicos deben tenerse en cuenta para desarrollar estrategias de prevención. (AU)

Introduction and objectives To determine the incidence of sports-related sudden cardiac death in Spain, and to identify the clinical-pathological characteristics, substance abuse, and sports activity associated with this entity.MethodsRetrospective, population-based, multicenter study of forensic autopsies conducted in 25 provinces during an 8-year period (2010-2017).ResultsWe investigated 288 cases (98.6% occurred in men with a mean age of 43.8±14.4 years). The incidence in the general population was 0.38 cases out of 100 000 inhabitants per year (0.82 among regular athletes), and most cases (54%) occurred in persons aged between 35 and 54 years. The most frequent sports (96% recreational) were cycling (28%), football (18%), and jogging (17%). Death was of cardiovascular origin in 99%. The main causes were ischemic heart disease (63%), cardiomyopathies (21%), and sudden arrhythmic death syndrome (6%). In young people, cardiomyopathies (38%) and ischemic heart disease (30%), present after the age of 20 years, were the most prevalent. The disease was diagnosed during life in 23 cases, relevant clinical antecedents were observed in 30 cases, and cardiovascular risk factors, mainly obesity, in 95 cases. Toxicological analysis detected cardiotoxic substances in 7%, highlighting the association between cannabis and acute ischemic heart disease.ConclusionsSports-related sudden cardiac death in Spain has a very low incidence and affects middle-aged men practicing recreational sports, mainly cycling, football, and jogging. This entity is of cardiovascular origin with early onset of ischemic heart disease. Clinical data and substance abuse should be taken into account to develop preventive strategies. (AU)

Sports-related sudden cardiac death in Spain. A multicenter, population-based, forensic study of 288 cases.

INTRODUCTION AND OBJECTIVES: To determine the incidence of sports-related sudden cardiac death in Spain, and to identify the clinical-pathological characteristics, substance abuse, and sports activity associated with this entity. METHODS: Retrospective, population-based, multicenter study of forensic autopsies conducted in 25 provinces during an 8-year period (2010-2017). RESULTS: We investigated 288 cases (98.6% occurred in men with a mean age of 43.8±14.4 years). The incidence in the general population was 0.38 cases out of 100 000 inhabitants per year (0.82 among regular athletes), and most cases (54%) occurred in persons aged between 35 and 54 years. The most frequent sports (96% recreational) were cycling (28%), football (18%), and jogging (17%). Death was of cardiovascular origin in 99%. The main causes were ischemic heart disease (63%), cardiomyopathies (21%), and sudden arrhythmic death syndrome (6%). In young people, cardiomyopathies (38%) and ischemic heart disease (30%), present after the age of 20 years, were the most prevalent. The disease was diagnosed during life in 23 cases, relevant clinical antecedents were observed in 30 cases, and cardiovascular risk factors, mainly obesity, in 95 cases. Toxicological analysis detected cardiotoxic substances in 7%, highlighting the association between cannabis and acute ischemic heart disease. CONCLUSIONS: Sports-related sudden cardiac death in Spain has a very low incidence and affects middle-aged men practicing recreational sports, mainly cycling, football, and jogging. This entity is of cardiovascular origin with early onset of ischemic heart disease. Clinical data and substance abuse should be taken into account to develop preventive strategies.

Effect of GnRH agonist before IVF on outcomes in infertile endometriosis patients: a randomized controlled trial.

RESEARCH QUESTION: Does 3-months of gonadotrophin releasing hormone agonist (GnRHa) treatment before IVF improve clinical pregnancy rate in infertile patients with endometriosis? DESIGN: Single-blind, placebo-controlled clinical trial of 200 infertile women with endometriosis assigned to use GnRHa (study group) or placebo (control group) for 3 months before IVF. Clinical, embryological outcomes and stimulation parameters were analysed. Clinical pregnancy rate was the primary endpoint. In a subgroup of 40 patients, follicular fluid levels of oestradiol, testosterone and androstendione were measured. Gene expression profile of CYP19A1 was analysed in cumulus and mural granulosa cells. RESULTS: Implantation or clinical pregnancy rate were not significantly different between the two groups. Clinical pregnancy rates were 25.3% and 33.7% in the study and control groups, respectively (P = 0.212). Cumulative live birth rate was not significantly different: 22.0% (95% CI 13.0 to 31.0) in the study group and 33.7% (95% CI 24.0 to 44.0) in the control group (P = 0.077). Ovarian stimulation was significantly longer and total dose of gonadotrophins significantly higher in the study group (both P < 0.001). Serum oestradiol levels on the day of HCG were significantly lower in the study group (P = 0.001). Cancellation rate was significantly higher in the study group (P = 0.042), whereas cleavage embryos were significantly more numerous in the control group (P = 0.023). No significant differences in the expression of CYP19A1 gene in mural or cumulus granulosa cells or steroid levels in follicular fluid between the two groups were observed, but testosterone was significantly lower in the study group (P < 0.001). CONCLUSION: Three-months of GnRHa treatment before IVF does not improve clinical pregnancy rate in women with endometriosis.

The Role of Imaging Biomarkers in the Assessment of Sarcopenia.

BACKGROUND: The diagnosis of sarcopenia through clinical assessment has some limitations. The literature advises studies that include objective markers along with clinical assessment in order to improve the sensitivity and specificity of current diagnostic criteria. The decrease of muscle quality precedes the loss of quantity, so we studied the role magnetic resonance imaging biomarkers as indicators of the quantity and quality of muscle in sarcopenia patients. METHODS: a cross-sectional analysis was performed to analyze what MR-derived imaging parameters correlate better with sarcopenia diagnostic criteria in women of 70 years of age and over (independent walking and community-dwelling women who were sarcopenic in accordance with EWGSOP criteria with muscle mass adjusted to Spanish population were chosen). RESULTS: The study included 26 women; 81 ± 8 years old. A strong correlation was obtained between cineanthropometric variables (BMI; thigh perimeter and fat mass) and imaging biomarkers (muscle/fat ratio, fatty infiltration, muscle T2*, water diffusion coefficient, and proton density fat fraction) with coefficients around 0.7 (absolute value). CONCLUSIONS: Knowing the correlation of clinical parameters and imaging-derived muscle quality indicators can help to identify older women at risk of developing sarcopenia at an early stage. This may allow taking preventive actions to decrease disability, morbidity, and mortality in sarcopenia patients.

Efectos de un programa de promoción de hábitos saludables desde la enfermería en el ámbito escolar: estudio cuasi-experimental / Effects of a program focusing on the promotion of health habits in the school from the infirmary field: quasy-experimental study

OBJETIVOS: Analizar los efectos de un programa de promoción de hábitos saludables impartido por la enfermera comunitaria sobre los hábitos y conocimientos de salud en escolares de 5º y 6º de primaria. MÉTODO: Diseño cuasi-experimental, con dos grupos paralelos, con mediciones pre-post intervención. La muestra quedó conformada por 144 estudiantes repartidos en grupo control (GC; n=65) y grupo intervención (GI; n=79). Las variables que se valoraron fueron los conocimientos y los hábitos de salud, mediante el Test de Conocimientos de Hábitos Saludables y el Inventario de Hábitos Saludables. RESULTADOS: Después de la intervención se encontraron diferencias estadísticamente significativas en el test de conocimientos (p < 0.01) y en la calidad (p < 0.05) y frecuencia alimentaria (p < 0.05) del alumnado incluido en el GI. Por el contrario, no se encontraron cambios significativos (p＞0.05) en las horas semanales de práctica de actividad física, ni en las horas semanales de ocio sedentario, ni en las horas de descanso nocturno. A pesar de no obtener cambios significativos, sí que se observa que, tras la intervención, un 67,1% del alumnado del GI dedicaba menos de 2 horas de ocio sedentario al día, frente al 55% del GC. En cuanto a la práctica de actividad física, el 63,3% del alumnado del GI realizaba más de 60 minutos/día tras la intervención frente al 58,5% del GC. CONCLUSIONES: Un programa de promoción de hábitos saludables llevado a cabo por una enfermera comunitaria en un centro escolar de primaria ayuda a mejorar los conocimientos de salud y, como consecuencia, los hábitos de salud de los escolares. En este sentido, la influencia de la enfermera escolar sería determinante para la adquisición de hábitos de salud en escolares, dado que garantiza la intervención continua y prolongada durante toda la etapa de educación primaria

OBJECTIVES: To analyze the effects of a health habits promotion program taught by the community nurse about health habits and knowledge in school children of 5º and 6º primary school. METHOD: Quasi-experimental design, with two parallel groups, with pre-post intervention tests. The sample consisted of 144 students divided into a control group (GC, n = 65) and an intervention group (GI, n = 79). The variables that were assessed were knowledge and health habits using the Healthy Habits Knowledge Test and the Healthy Habits Inventory. RESULTS: After the intervention, we found statistically significant differences in the knowledge test (p <0.01) and in the food quality (p <0.05) and food frequency (p <0.05) of the GI students. There were no significant changes (p> 0.05) in the weekly hours of physical practice, sedentary lifestyle and night rest. Despite not obtaining significant differences, it is observed that 67.1% of the GI students spend less than 2 sedentary hours per day compared to 55% of the CG, after the intervention. In terms of the practice of physical activity, 63.3% of the GI students performed more than 60 minutes / day after the intervention compared to 58.5% of the CG. CONCLUSIONS: A program to promote healthy habits carried out by a community nurse in a primary school improves health knowledge and, as a consequence, the health habits of the students. In this sense, the influence of the school nurse would be essential for the acquisition of health habits in schoolchildren, since it guarantees continuous and prolonged intervention during the whole stage of primary education

[Lifestyle and physical condition factors associated with gender-specific BMI in Spanish preadolescents]. / Factores relacionados con el estilo de vida y la condición física que se asocian al IMC en función del género en preadolescentes españoles.

INTRODUCTION: Obesity has become one of the most serious health problems in our society and is associated with a multitude of conditions and complications at puberty. Through this descriptive, cross-sectional study we intended, first, to know the differences by gender in lifestyle and physical condition variables, and second, to know the determinants related to lifestyle and physical condition for a Spanish population aged 10 to 12 years with a medium socioeconomic status. The variables analyzed were BMI, physical condition variables (agility, flexibility, and cardiorespiratory capacity), and health habit variables (quality and frequency of food, physical activity, sedentary lifestyle, and sleep duration). We found significant differences between girls and boys in food quality and frequency, physical activity, sedentary lifestyle, flexibility, and maximum oxygen consumption variables. In the predictive analysis, the models significantly predicted the BMI for the total sample, the group of boys, and the group of girls. Explanatory variables include quality of breakfast, sedentary lifestyle, VO2 max and agility.

INTRODUCCIÓN: La obesidad se ha convertido en uno de los problemas de salud más graves de la sociedad y se relaciona con multitud de afecciones y complicaciones en la pubertad. Mediante este estudio descriptivo, transversal y poblacional se pretende, en primer lugar, conocer las diferencias entre las variables del estilo de vida y la condición física de cada género y, en segundo lugar, conocer los determinantes relacionados con el estilo de vida y la condición física en una población española de 10 a 12 años de edad con nivel socioeconómico medio. Las variables analizadas fueron el IMC, las variables de condición física (agilidad, flexibilidad y capacidad cardiorrespiratoria) y las variables de los hábitos de salud (calidad y frecuencia alimentaria, práctica de actividad física, sedentarismo y descanso nocturno). Encontramos diferencias significativas entre chicas y chicos para las variables de calidad y frecuencia alimentarias, actividad física, sedentarismo, flexibilidad y consumo máximo de oxígeno. En el análisis predictivo, los modelos predijeron significativamente el IMC de la muestra total, del grupo de chicos y del grupo de chicas, siendo las variables explicativas la calidad del desayuno, el sedentarismo de pantalla, el VO2 máx y la agilidad.

Sports-related sudden cardiac death due to myocardial diseases on a population from 1-35 years: a multicentre forensic study in Spain.

This is a multicentre forensic study that identifies all sports-related sudden deaths (SRSDs) in young people, due to myocardial diseases (MDs) that occurred in a large area of Spain. The aim of the study is to assess the epidemiology, causes of death, and sport activities associated with these fatalities. This is a retrospective study based on forensic autopsies performed in the provinces of Biscay, Seville, Valencia and in the jurisdiction covered by the National Institute of Toxicology and Forensic Sciences in Madrid (Spain). The retrospective study encompasses from 2010 to 2017. All sudden cardiac deaths (SCDs) in persons 1-35 years old were selected. The total number of SCDs were divided into death occurred during exercise (SRSD) and death during rest, sleep or normal activities (non-SRSD). Each of these two groups was subdivided according to the cause of death into MD (primary cardiomyopathies and myocarditis) and non-MD. Clinic-pathological, toxicological and genetic characteristics of SRSD due to MD were analysed. Over the 8-year study period, we identified 645 cases of SCD in the young: 75 SRSD (11.6%) and 570 non-SRSD (88.4%). MD was diagnosed in 33 (44.0%) of the SRSD and in 112 (19.6%) of the non-SRSD cases. All cases of SRSD due to MD were males (mean age (24.0 ± 7.6) years) practicing recreational sports (85%). SRSDs were more frequent in arrhythmogenic cardiomyopathy (ACM) (37%) and hypertrophic cardiomyopathy (HCM) (24%), followed by myocarditis (15%) and idiopathic left ventricular hypertrophy (ILVH) (9%). Only in five cases of SRSD the MD responsible of death (HCM) had been diagnosed in life. Cardiovascular symptoms related to the disease were present in other seven patients (six of them with ACM). Postmortem genetic studies were performed in 15/28 (54%) primary cardiomyopathies with positive results in 12 (80%) cases. The most frequent sports disciplines were football (49%) followed by gymnastics (15%) and running (12%). In Spain, SRSD in young people due to MDs occurs in males who perform a recreational activity. Compared with control group we observed a strong association between MDs and exertion. One in three SRSDs are due to cardiomyopathy, especially ACM, which reinforces the need for preparticipation screening to detect these pathologies in recreational sport athletes. Further studies are warranted to understand the causes and circumstances of sudden death to facilitate the development of preventive strategies.

The Cerebellum of Patients with Steatohepatitis Shows Lymphocyte Infiltration, Microglial Activation and Loss of Purkinje and Granular Neurons.

Peripheral inflammation contributes to minimal hepatic encephalopathy in chronic liver diseases, which could be mediated by neuroinflammation. Neuroinflammation in cerebellum of patients with chronic liver diseases has not been studied in detail. Our aim was to analyze in cerebellum of patients with different grades of liver disease, from mild steatohepatitis to cirrhosis and hepatic encephalopathy: (a) neuronal density in Purkinje and granular layers; (b) microglial activation; (c) astrocyte activation; (d) peripheral lymphocytes infiltration; (e) subtypes of lymphocytes infiltrated. Steatohepatitis was classified as SH1, SH2 and SH3. Patients with SH1 show Th17 and Tfh lymphocytes infiltration in the meninges, microglia activation in the molecular layer and loss of 16 ± 4% of Purkinje and 19 ± 2% of granular neurons. White matter remains unaffected. With the progression of liver disease to worse stages (SH2, SH3, cirrhosis) activation of microglia and astrocytes extends to white matter, Bergman glia is damaged in the molecular layer and there is a further loss of Purkinje neurons. The results reported show that neuroinflammation in cerebellum occurs at early stages of liver disease, even before reaching cirrhosis. Neuroinflammation occurs earlier in the molecular layer than in white matter, and is associated with infiltration of peripheral Th17 and Tfh lymphocytes.

Endoscopic recommendations for colorectal cancer screening and surveillance in patients with inflammatory bowel disease: Review of general recommendations.

Screening for colorectal cancer (CRC) in patients with inflammatory bowel disease (IBD) is recommended by all scientific societies. However, there are differences in the recommendations they make regarding screening and surveillance. We address a series of questions that come up in the daily clinical practice of a physician. The first two questions that are raised are: (1) Who should be offered screening for CRC? and (2) When should the first colonoscopy be performed? The next step is to decide who should undergo endoscopic surveillance and at what intervals they should be performed. Chromoendoscopy is emerging as the recommended endoscopic technique for screening and surveillance. The terminology for describing lesions detected with endoscopy is also changing. The management of visible lesions or non-visible dysplasia is also a motive for the review. We end the review by addressing the follow-up for endoscopically resected lesions. These questions often cannot be answered easily due to the varying degrees of evidence available; therefore, we have made some general recommendations based on those made by the various guidelines and consensuses. The first screening colonoscopy should be offered 8 years after a IBD diagnosis and we recommend that patients be stratified according to the individual risk for each for endoscopic surveillance intervals.

Ultrastructural characteristics of human oocytes vitrified before and after in vitro maturation.

The development of an effective program that combines in vitro maturation (IVM) and cryopreservation for immature oocytes would represent a novel advance for in vitro fertilization (IVF), especially as a means to preserve the fertility of women in unique situations. The aim of this study was to analyze the ultrastructural characteristics of human oocytes, obtained after controlled ovarian stimulation, to determine whether IVM is best performed before or after vitrification. To this end, we analyzed the following features in a total of 22 MII oocytes: size, zona pellucida and perivitelline space, mitochondria number, M-SER (mitochondria-smooth endoplasmic reticulum) aggregates and M-V (mitochondria-vesicle) complexes, the number of cortical granules and microvilli, and the presence of vacuolization using transmission electron microscopy (TEM). Each oocyte presented a rounded shape, with an intact oolemma, and was surrounded by a continuous zona pellucida and perivitelline space. Statistical analysis comparing oocytes vitrified before or after IVM indicated that there were no significant differences between examined characteristics.

Regulación metabólica de la fertilidad. Integración neuroendocrina / Fertility metabolic regulation. Neuroendocrine integration

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Regulación de la actividad GnRH. Los sistemas Kisspeptina/GPR54 y GnIH/GPR147 / GnRH activity regulation. Kisspeptin/GPR54 and GnIH/GPR147 systems

OBJETIVO: Revisar y actualizar la fisiología de la regulación de fertilidad y reproducción, poniendo especial énfasis en los factores neuroendocrinos que controlan la secreción pulsátil de GnRH. MATERIAL Y MÉTODOS: Revisión bibliográfica, utilizando como palabras clave «GnRH», «Kisspeptin», «GnIH», «RF-amide» y RPRF-3, entre otras. RESULTADOS: Siendo la secreción pulsátil de GnRH el elemento clave para el control de la secreción de gonadotrofinas, se describen los mecanismos neuroendocrinos (Kisspeptina, GnIH) que regulan la actividad de las neuronas GnRH

OBJECTIVE: To Review and update the physiology regulating fertility and reproduction, with particular emphasis on neuroendocrine factors controlling the pulsatile secretion of GnRH. MATERIAL AND METHODS: Review of the literature, using as key words «GnRH», «Kisspeptin», «GnIH», «RF-amide» and RPRF-3, among others. RESULTS: Being the pulsatile secretion of GnRH the key element for the control of gonadotrophin secretion, the neuroendocrine mechanisms (Kisspeptine, GnIH) that regulate the activity of GnRH neurons are described

RELATIONSHIP BETWEEN TRAINING VOLUME AND BONE MINERAL DENSITY CHANGES IN ELDERLY WOMEN / RELAÇÃO ENTRE O VOLUME DE TREINAMENTO E MUDANÇAS DE DENSIDADE MINERAL ÓSSEA EM MULHERES IDOSAS / RELACIÓN ENTRE VOLUMEN DE ENTRENAMIENTO Y CAMBIOS EN LA DENSIDAD MINERAL ÓSEA EN MUJERES MAYORES

ABSTRACT Introduction: Several studies have analyzed the relationship between physical activity and bone density. However, the prescription of exercise is not entirely clear as to the type, quantity and intensity. Objective: The objective of this study was to determine if there is a relationship between the amount of exercise and changes in bone mineral density. Methods: Fifty-two women, members of the Municipal Program of Physical Activity for Seniors, voluntarily underwent two ultrasonographies of the calcaneus within a 6-month interval. During this period, all physical activity was recorded. Afterwards, a lineal correlation study was carried out between the amount of exercise and bone changes, expressed as T-Score variation, first in total number of participants and then in groups. Considering the average body weight obtained for all women, two groups were created ("light" < 69 kg and "heavy" > 69 kg). Later, women who had participated in less than 72% of the targeted program were excluded from both groups, and the differences between the groups "light and trained" and "heavy and trained" were analyzed. To do so, the nonparametric Mann-Whitney U test was used. Results: A significant relationship of r= -0.59 was found between the total amount of exercise and the T-Score variation in the group of women above 69 kg. Significant differences were found between the "light and trained" group and the "heavy and trained" group with respect to the variation of T-Score. Conclusion: The effect of exercise on bone mineral density is determined, somehow, by body weight. This interaction is due, possibly, to mechanical demands difference.

RESUMO Introdução: Vários estudos analisaram a relação à quantidade de atividade física e densidade óssea. No entanto, a prescrição de exercício físico não é totalmente clara, em relação ao tipo, quantidade e intensidade. Objetivos: o objetivo deste estudo foi determinar se existe relação entre a quantidade de exercício físico e alterações na densidade óssea. Métodos: 52 mulheres, membros do programa municipal de atividade física para idosos participaram voluntariamente na realização de dois ultrassonografias de calcâneo, separado 6 meses. Durante este período, toda a atividade física foi registrada. Em seguida, foi realizado um estudo de correlação linear entre a quantidade de exercício físico e alterações ósseas, expressos como variação do T-Score, primeiro de maneira conjunta e despois em grupos. Considerando-se o peso corporal médio obtido para todas as mulheres, dois grupos foram criados ("magro" < 69Kg e "pesado" > 69Kg). Mais tarde, as mulheres que tinham participado em menos do 72% do programa alvejado foram excluídas de ambos os grupos, e foram analisadas as diferenças entre o grupo "magro e treinado" e o grupo "pesado e treinado". Para alcançar este objetivo, foi utilizado o teste não paramétrico da U de Mann-Whitney. Resultados: foi encontrada ama relação significativa de r = -0,59 entre a quantidade total do exercício físico e da variação do T-Score, no grupo das mulheres de mais do que 69Kg. Foram encontradas diferenças significativas entre o grupo "magro y treinado" e o grupo "pesado e treinado", em relação à variação do T-Score. Conclusão: o efeito do exercício físico na densidade mineral óssea é determinado de alguma forma, pelo peso corporal. Esta interação é possivelmente devida à diferente demanda mecânica.

RESUMEN Introducción: Diversos estudios han analizado la relación entre la actividad física y la densidad ósea. Sin embargo, la prescripción de ejercicio físico no está completamente clara en relación al tipo, cantidad e intensidad. Objetivo: El objetivo de este estudio fue determinar si existe relación entre la cantidad de ejercicio y los cambios en la densidad mineral ósea. Métodos: Cincuenta y dos mujeres, integrantes del Programa Municipal de Actividad Física para Mayores, participaron voluntariamente en la realización de dos ultrasonografías de calcáneo, con intervalo de 6 meses. Durante este periodo, se registró toda la actividad física. A continuación, se realizó un estudio de correlación lineal entre la cantidad de ejercicio y cambios óseos, expresados como la variación del T-Score, primero de forma conjunta y posteriormente por grupos. Teniendo en cuenta el peso corporal medio obtenido para el total de mujeres, se crearon dos grupos ("ligero" < 69 Kg y "pesado" > 69 Kg). Más tarde, las mujeres que habían participado en menos del 72% del programa dirigido fueron excluidas de ambos grupos y se analizaron las diferencias entre el grupo "ligero y entrenado" y el grupo "pesado y entrenado". Para lograr este objetivo, se utilizó la prueba no paramétrica de la U de Mann-Whitney. Resultados: Se encontró una relación significativa de r= -0,59 entre la cantidad total de ejercicio físico y la variación del T-Score en el grupo de mujeres de más de 69 Kg. Se encontraron diferencias significativas entre el grupo "ligero y entrenado" y el grupo "pesado y entrenado" con respecto a la variación del T-Score. Conclusión: El efecto del ejercicio físico sobre la densidad mineral ósea está determinado, de alguna manera, por el peso corporal. Esta interacción es debida posiblemente a la diferente demanda mecánica.