Effect of ß-glucans on rainbow trout (Oncorhynchus mykiss) IgM+ B cells.

ß-glucans are carbohydrates present in the cell wall of many fungi, which are often used as immunostimulants in feeds for farmed species. Their capacity to activate innate immune responses directly acting on innate cell populations has been widely documented in fish. However, whether they can affect the functionality of adaptive immune cells has been scarcely explored. In this context, in the current work, we have determined the effects of ß-glucans on rainbow trout blood IgM+ B cells in the presence or absence of 2,4,6-trinitrophenyl hapten conjugated to lipopolysaccharide (TNP-LPS), a model antigen. For this, rainbow trout peripheral blood leukocytes were incubated with different doses of ß-glucans or media alone in the presence or absence of TNP-LPS for 48 h. The size, levels of expression of surface MHC II, antigen processing and phagocytic capacities and proliferation of IgM+ B cells were then studied by flow cytometry. The number of IgM-secreting cells in the cultures was also estimated by ELISpot. ß-glucans significantly decreased the levels of surface MHC II expression and the antigen processing capacities of these cells, especially in the presence of TNP-LPS, while they increased their phagocytic activity. On their own, ß-glucans slightly activated the proliferation of IgM+ B cells but reduced that induced by TNP-LPS. In contrast, ß-glucans significantly increased the number of cells secreting IgM in the cultures. This effect of ß-glucans on the IgM-secreting capacity of B cells was also confirmed through a feeding experiment, in which the IgM-secreting capacity of blood leukocytes obtained from fish fed a ß-glucan-supplemented diet for one month was compared to that of leukocytes obtained from fish fed a control diet. Altogether, these findings contribute to increase our knowledge regarding the effects of ß-glucans on fish adaptive responses.

Immunomodulatory properties of Bacillus subtilis extracellular vesicles on rainbow trout intestinal cells and splenic leukocytes.

Extracellular vesicles (EVs) are cell-derived membrane-surrounded vesicles that carry bioactive molecules. Among EVs, outer membrane vesicles (OMVs), specifically produced by Gram-negative bacteria, have been extensively characterized and their potential as vaccines, adjuvants or immunotherapeutic agents, broadly explored in mammals. Nonetheless, Gram-positive bacteria can also produce bilayered spherical structures from 20 to 400 nm involved in pathogenesis, antibiotic resistance, nutrient uptake and nucleic acid transfer. However, information regarding their immunomodulatory potential is very scarce, both in mammals and fish. In the current study, we have produced EVs from the Gram-positive probiotic Bacillus subtilis and evaluated their immunomodulatory capacities using a rainbow trout intestinal epithelial cell line (RTgutGC) and splenic leukocytes. B. subtilis EVs significantly up-regulated the transcription of several pro-inflammatory and antimicrobial genes in both RTgutGC cells and splenocytes, while also up-regulating many genes associated with B cell differentiation in the later. In concordance, B. subtilis EVs increased the number of IgM-secreting cells in splenocyte cultures, while at the same time increased the MHC II surface levels and antigen-processing capacities of splenic IgM+ B cells. Interestingly, some of these experiments were repeated comparing the effects of B. subtilis EVs to EVs obtained from another Bacillus species, Bacillus megaterium, identifying important differences. The data presented provides evidence of the immunomodulatory capacities of Gram-positive EVs, pointing to the potential of B. subtilis EVs as adjuvants or immunostimulants for aquaculture.

L-methionine supplementation modulates IgM+ B cell responses in rainbow trout.

The interest in dietary amino acids (AAs) as potential immunomodulators has been growing the recent years, since specific AAs are known to regulate key metabolic pathways of the immune response or increase the synthesis of some immune-related proteins. Methionine, tryptophan and lysine are among the ten essential AAs for fish, meaning that they cannot be produced endogenously and must be provided through the diet. To date, although dietary supplementation of fish with some of these AAs has been shown to have positive effects on some innate immune parameters and disease resistance, the effects that these AAs provoke on cells of the adaptive immune system remained unexplored. Hence, in the current study, we have investigated the effects of these three AAs on the functionality of rainbow trout (Oncorhynchus mykiss) IgM+ B cells. For this, splenic leukocytes were isolated from untreated adult rainbow trout and incubated in culture media additionally supplemented with different doses of methionine, tryptophan or lysine in the presence or absence of the model antigen TNP-LPS (2,4,6-trinitrophenyl hapten conjugated to lipopolysaccharide). The survival, IgM secreting capacity and proliferation of IgM+ B cells was then studied. In the case of methionine, the phagocytic capacity of IgM+ B cells was also determined. Our results demonstrate that methionine supplementation significantly increases the proliferative effects provoked by TNP-LPS and also up-regulates the number of cells secreting IgM, whereas tryptophan or lysine have either minor or even negative effects on rainbow trout IgM+ B cells. This increase in the number of IgM-secreting cells in response to methionine surplus was further verified in a feeding experiment, in which the beneficial effects of methionine on the specific response to anal immunization were also confirmed. The results presented demonstrate the beneficial effects of dietary supplementation with methionine on the adaptive immune responses of fish.

Multitask learning-driven identification of novel antitrypanosomal compounds.

Background: Chagas disease and human African trypanosomiasis cause substantial death and morbidity, particularly in low- and middle-income countries, making the need for novel drugs urgent. Methodology & results: Therefore, an explainable multitask pipeline to profile the activity of compounds against three trypanosomes (Trypanosoma brucei brucei, Trypanosoma brucei rhodesiense and Trypanosoma cruzi) were created. These models successfully discovered four new experimental hits (LC-3, LC-4, LC-6 and LC-15). Among them, LC-6 showed promising results, with IC50 values ranging 0.01-0.072 µM and selectivity indices >10,000. Conclusion: These results demonstrate that the multitask protocol offers predictivity and interpretability in the virtual screening of new antitrypanosomal compounds and has the potential to improve hit rates in Chagas and human African trypanosomiasis projects.

Measuring patient safety climate in operating rooms: Validation of the Spanish version of the hospital survey on patient safety.

OBJECTIVE: The measurement of patient safety climate within hospitals, and specifically in operating rooms is a basic tool for the development of the patient's safety policy. There are no validated Spanish versions of instruments to measure safety climate. The objective of this research was to validate the Spanish version of the Hospital Survey on Patient Safety (HSOPS®), with the addition of a module for surgical units, to evaluate the patient safety climate in operating rooms. METHODS: Survey validation study. The Hospital Survey on Patient Safety (HSOPS®) was applied to health workers from 6 acute general hospitals, from Medellín (Colombia), with surgical procedures greater than 300 per month, 18 items were added considered specific for Operating Rooms. For construct validation, an exploratory factor analysis (EFA) was used, utilizing principal components as the extraction method. Reliability was evaluated with Cronbach's α. RESULTS: A 10 dimensions model was obtained with EFA, most of the dimensions of the original questionnaire were conserved, although the factorial structure was not reproduced. Two new dimensions emerged from the added items. The Cronbach's α ranged between 0.66 and 0.87. Conclusions: We found the HSOPS questionnaire is valid and reliable for measuring patient safety climate in Spanish speaking Latin American countries. Two additional dimensions are proposed for Operating Rooms.

Proboscis lateralis with rhinosinusitis

OBJECTIVE: This report aims to describe unique manifestations of proboscis lateralis and highlight the importance of a multidisciplinary approach to address the problems that arise from this rare congenital anomaly.METHODS:Design: Case ReportSetting: Tertiary Government HospitalPatient: OneRESULTS: A 13-year-old girl diagnosed with proboscis lateralis presented with a trunk-like appendage projecting from the surface of the right supramedial canthal area. She also had clear nasal discharge, nasal congestion, mouth-breathing and snoring since birth. Paranasal Sinus (PNS) CT scan with 3D reconstruction showed agenesis of the right paranasal sinuses and expansile aeration of the left paranasal sinuses. Due to her condition, the drainage system of the paranasal sinuses was obstructed causing chronic rhinosinusitis (CRS). This hindered plans for reconstructive surgery despite medical management, hence, the patient underwent Endoscopic Sinus Surgery (ESS).CONCLUSIONS: Proboscis lateralis is a rare congenital anomaly that results in aesthetic problems as well as airway concerns such as rhinosinusitis and obstructive sleep apnea syndrome (OSAS). Management entails a multidisciplinary approach to address functional and aesthetic problems of the patient.

True congenital macroglossia surgically managed using a modified Kole technique

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> To describe a 2-year-old boy with true congenital macroglossia surgically managed using a modified Kole technique.<br /><strong>METHODS:</strong> <br /><strong>Design:</strong> Surgical Innovation<br /><strong>Setting:</strong> Tertiary Government Hospital<br /><strong>Patient:</strong> One<br /><strong>RESULTS:</strong> A 2-year-old boy presented with congenital macroglossia, associated with difficulty feeding and phonating. On physical examination, the massive tongue had both increased length and width. At rest, it protruded between the upper and lower teeth with drying and fissuring of the tip. Dribbling of saliva and mandible prognathism were also noted. The child was surgically treated with a modified Kole technique, wherein the apex of the anterior wedge resection was extended to the posterior third midline. Final histopathology was consistent with cavernous hemangioma.<br /><strong>CONCLUSION:</strong> The modified Kole technique proved viable as the preoperative results were considered satisfactory. Tongue volume was uniformly reduced in length and width enabling mouth and jaw closure while tongue sensation and mobility were preserved. Feeding, speech intelligibility and cosmesis were markedly improved. Future application of this modification may prove its usefulness.</p>

Study of the factors influencing the preparation of advance directives.

The aim of the study is to analyze the factors influencing the decision to prepare advance directives (AD) related to socio-demographic situation, health status, degree of dependence, healthcare characteristics and psychosocial aspects. This is a case-control study conducted using a personal interview. We compared 123 subjects who had completed AD with 123 subjects who had not and who belonged to two health centers in the Albacete Health District. Study variables included self-perceived health, functional status, morbidity, socio-demographic characteristics, use of health services, attitudes toward AD and psychosocial aspects. We found a predominance of women (64.2%) among those who prepared AD, with a mean age of 53.3 years. Preparing AD was associated with secondary or higher education (OR=2.5), a lifestyle other than living with a partner and with children (OR=2.5), chronic medication use (OR=3.2), higher than average number of specialist visits (OR=4.0), a longer-term relationship with the family physician (OR=3.5), a family history of having AD (OR=17.3) and with lower levels of social interaction (OR=3.0). The results suggest that several factors, resulting from both the socio-demographic situation and health or functional status, can affect the decision to formalize AD.

Genetic polymorphisms in CYP1A1, GSTM1, GSTP1, GSTT1, NAT1 and NAT2 and oral cavity cancer risk among Filipinos

Polymorphisms in metabolic genes have been shown to modulate susceptibility to oral cavity cancer. Cases (n=176) and controls (n=317) from the Filipino population were genotyped for selected polymorphisms in CYP1A1, GSTM1, GSTP1, GSTT1, NAT1 and NAT2. Medical and diet histories, occupational exposure and demographic data were also collected for all subjects. The CYP1A1m1/m1 genotype is protective against oral cancer, while being homozygous for the GSTP1 c.313G genotype and heterozygous for the NAT1*10 homozygotes and non-homozygotes for the CYP1A1 m1 allele. The risk from heterozygosity for the NAT1*10 allele was limited to subjects who were not homozygous for the GSTP1 c.313G genotype remained a significant oral cancer risk modifier, together with environmental variables, the homozygous GSTP1 c.313G genotype remained a significant oral cancer risk modifier, together with environmental risk factors, such as smoking, passive smoking, inverted smoking and tobacco chewing, and environmental protective factors, i.e. moderate consumption of fish sauce (patis) and shrimp paste (bagoong). The GSTP1 c.313G polymorphism increases susceptibility for oral cavity cancer in the Filipino population.

Factors associated with parietal cell autoantibodies in the general population.

The presence in serum of parietal cell autoantibodies (PCA) is a characteristic of autoimmune gastritis. We determined the prevalence of PCA in the general population and investigate their association with type 2 diabetes, insulin resistance and lifestyle factors related with autoimmune gastritis. A cross-sectional study was performed, involving 429 individuals enrolled in a cohort study of the general population of the Canary Islands. All participants underwent physical examination, provided a blood sample and responded to a questionnaire regarding health and lifestyle factors. Serum concentrations of PCA, soluble CD40 ligand (sCD40L), C-peptide and glucose (to determine insulin resistance) were measured. The association of PCA with the other factors was determined with bivariate analysis, and logistic regression models were used to adjust the associations for age and sex. The prevalence of PCA was 7.8% (95% CI=10.3-5.3). The factors associated with PCA were female sex (p=0.032), insulin resistance (p=0.016), menopause (p=0.029) and sCD40L (p=0.019). Alcohol consumption (p=0.006) and smoking (p=0.005) were associated with low prevalences of PCA. After adjustment for age and sex, the association with PCA was confirmed for smoking (OR=0.1 [0.0-0.9]), alcohol consumption (OR=0.3 [0.1-0.9]), insulin resistance (OR=2.4 [1.1-4.9]), female sex (OR=2.4 [1.1-5.3]), sCD40L (OR=3.7 [1.2-11.4]) and menopause (OR=5.3 [1.2-23.3]). In conclusion, smoking and alcohol consumption acted as protective factors against the appearance of PCA in the general population, whereas female sex, menopause, insulin resistance and elevated serum sCD40L were risk markers for PCA. In patients who smoke or drink alcohol, clinicians should be cautious when using PCA to rule out autoimmune gastritis.

Nasal allergies in the Asian-Pacific population: results from the Allergies in Asia-Pacific Survey.

BACKGROUND: The Allergies in Asia-Pacific Survey describes the symptoms, impact, and treatment of allergic rhinitis (AR) across Australia, China, Hong Kong, Malaysia, Singapore, Taiwan, Vietnam, and the Philippines. The Allergies in Asia-Pacific Survey was undertaken to further clarify the prevalence of physician-diagnosed nasal allergies (NAs), impact on quality-of-life (QOL), existing treatment paradigms and gaps, and NA medications currently used in treatment. METHODS: Thirty-three thousand three hundred seventy-eight households were screened for individuals, ≥ 4 years old, with a physician diagnosis of AR or NA and either symptoms or treatment in the past 12 months. Standardized questionnaires were used to make comparisons across regions. A total of 1043 adults and 192 children were included in the survey. RESULTS: Nine percent of participants were diagnosed with AR with two of three responding that their NAs were seasonal in nature. Nasal congestion was the most common and bothersome symptom of AR. Most participants reported that AR impacted their QOL with nearly one-half citing impairments in school/work performance/productivity. Sleep disturbances, secondary to AR, were also shown to be appreciable. Two-thirds of patients took medication for their AR. Less than one-quarter of survey respondents reported taking an intranasal corticosteroid and the satisfaction rate was similar to that of over-the-counter medications. The most common reasons cited for dissatisfaction were related to inadequate efficacy and bothersome side effects. CONCLUSION: AR appears to be extremely common across Asia-Pacific nations. Many individuals with AR suffer from symptoms that reduce QOL and treatment gaps exist with current therapies. Through identification of disease impact and highlighting treatment gaps, clinicians may better understand and treat AR, leading to improvements in overall patient satisfaction and QOL.

Nasal allergies in the Asian-Pacific population: Results from the Allergies in Asia-Pacific Survey.

BACKGROUND: The Allergies in Asia-Pacific Survey describes the symptoms, impact, and treatment of allergic rhinitis (AR) across Australia, China, Hong Kong, Malaysia, Singapore, Taiwan, Vietnam, and the Philippines. The Allergies in Asia-Pacific Survey was undertaken to further clarify the prevalence of physician-diagnosed nasal allergies (NAs), impact on quality-of-life (QOL), existing treatment paradigms and gaps, and NA medications currently used in treatment. METHODS: Thirty-three thousand three hundred seventy-eight households were screened for individuals, ≥4 years old, with a physician diagnosis of AR or NA and either symptoms or treatment in the past 12 months. Standardized questionnaires were used to make comparisons across regions. A total of 1043 adults and 192 children were included in the survey. RESULTS: Nine percent of participants were diagnosed with AR with two of three responding that their NAs were seasonal in nature. Nasal congestion was the most common and bothersome symptom of AR. Most participants reported that AR impacted their QOL with nearly one-half citing impairments in school/work performance/productivity. Sleep disturbances, secondary to AR, were also shown to be appreciable. Two-thirds of patients took medication for their AR. Less than one-quarter of survey respondents reported taking an intranasal corticosteroid and the satisfaction rate was similar to that of over-the-counter medications. The most common reasons cited for dissatisfaction were related to inadequate efficacy and bothersome side effects. CONCLUSION: AR appears to be extremely common across Asia-Pacific nations. Many individuals with AR suffer from symptoms that reduce QOL and treatment gaps exist with current therapies. Through identification of disease impact and highlighting treatment gaps, clinicians may better understand and treat AR, leading to improvements in overall patient satisfaction and QOL.

[Current clinical practice guidelines in type 2 diabetes: how should they be applied in primary care?]. / Guías actuales de práctica clínica en la diabetes mellitus tipo 2: ¿cómo aplicarlas en atención primaria?

Clinical practice guidelines should be drawn up with systematic methodology based on the best available evidence. Recommendations should be based on evaluation of the overall quality of the evidence and grading of the strength of recommendations. Consensus documents combine a review of the evidence with expert opinion in an attempt to reach some agreement in areas of uncertainty due to the lack of conclusive proof. The debate aroused by new treatments stimulates the production of documents advocating their use even when there are few long-term studies on their safety and efficacy. There are several methodologically rigorous international guidelines on diabetes (NGC, NICE, SIGN, CAD, ADA). The most recent debate has centered on the ADA-EASD treatment algorithm. In Spain, the production of clinical practice guidelines with analysis of the evidence and grading of recommendations remains scarce, although the most recent published guidelines show greater rigor. More common is the drafting of consensus documents by scientific societies with the aim of combining external evidence with experience and reflection. In Spain there are also organisms (such as GuíaSalud or Fisterra) that facilitate free access to guidelines drawn up by Spanish groups.

[Diabetes mellitus and cardiovascular risk. Is integrated therapy of type 2 diabetes and cardiovascular risk factors necessary?]. / La diabetes mellitus y el riesgo cardiovascular. ¿Es necesario el tratamiento integral de la diabetes mellitus tipo 2 y los factores de riesgo cardiovascular?

Cardiovascular disease (CVD) is the first cause of death in the Spanish population among both diabetics and non-diabetics. In diabetes, CVD is between 2 and 4 times more frequent, earlier and more aggressive. With current measures, approximately 50% of CVD can be prevented. The risk factors for CVD in diabetes are hypertension, dyslipidemia, smoking, obesity and sedentariness. More than 80% of patient with type 2 diabetes have hypertension and dyslipidemia and approximately 15% continue to smoke. However, all these factors are controlled in at least 10%. Although dyslipidemia is the most influential and least treated factor, the greatest benefit for CVD prevention is obtained with integrated intervention on all risk factors, reducing blood pressure to below 140/80 mmHg, low-density lipoprotein cholesterol (LDL-c) to below 100 mg/dl, encouraging smoking cessation, regular physical activity and maintaining a healthy weight (BMI < 25 kg/m²). In secondary prevention or persons with microvascular disease, the targets may be stricter (blood pressure 130/80 mmHg and LDL-c 80 mg/dl). Drug treatment should always include an angiotensin converting-enzyme inhibitor or an angiotensin II receptor antagonist and a statin. Aspirin should be reserved for patients in secondary prevention or with very high CV risk. Consequently, interventions should be prioritized according to the foreseeable risk for each patient, which can be estimated through the SCORE scale or other scales such as Regicor or UKPDS, with a SCORE > 5% indicating high risk. These high-risk patients should receive personalized care.

Concentration dependent effects of commonly used pesticides on activation versus inhibition of the quince (Cydonia Oblonga) polyphenol oxidase.

Polyphenol oxidase (PPO) catalyzes the oxidation of o-diphenols to their respective quinones which undergo autopolymerization and form dark pigments. The interaction of PPO with various substrates and effectors remains the focus of intensive investigations due to the enzyme's key role in pigments biosynthesis including animal melanogenesis and fruit/fungi enzymatic browning. In this study, the effect of a range of commonly used pesticides on the enzyme activity has been evaluated using the purified quince (Cydonia oblonga Miller) PPO. The biochemical analysis showed that, in the presence of high pesticide concentrations, the enzyme was competitively inhibited, particularly with benomyl, carbaryl, deltamethrine and parathion methyl for which inhibition constants (K(i)) were 8.3, 5.7, 12 and 4 microM, respectively. At lower pesticide concentrations (2-10 microM), however, the catecholase activity was significantly activated (p<0.01), suggesting a homotropic behavior of these chemical compounds. Furthermore, the use of in silico structure-based analyses, known as computational docking, highlighted the nature of the PPO-pesticides interactions and confirmed the in vitro observations. Catechol substrate and parathion methyl inhibitor showed lower total energy scores of -120.06 and -117.4 3 kcal mol(-1), indicating that these ligands had higher PPO-binding affinities. The obtained data bring to light new pesticide functional features of great interest in the medicinal, agro-chemical and environmental circles.

Repercusiones del síndrome de apneas e hipopneas obstructivas del sueño sobre el rendimiento físico / Effects of obstructive sleepapnoea-hypopnoea syndrome on physical performance

OBJETIVOS: comprobar si el Síndrome de apneas/hipopneas del sueño (SAOS) provoca un bajo rendimiento físico y si éste mejora con el tratamiento con CPAP nasal y objetivar si existe correlación entre dicho deterioro y los parámetros de severidad del mismo. MÉTODOS: Incluimos 32 pacientes diagnosticados de SAOS (24 severos con un índice apneas/hipopneas (IAH)≥50 y 8 moderados con un IAH entre 27 y 49), a los que se les realizó hemograma, proteínograma, gasometría arterial y prueba de ejercicio sobre tapiz rodante hasta esfuerzo máximo con determinación del consumo de oxígeno, antes y después de 30 días de tratamiento con CPAPn. RESULTADOS: La potencia máxima alcanzada fue en severos de 191,83±54 vatios antes y 215±57 después del tratamiento (p<0,001) y en moderados de 136,75±54 y 145,87±65 (p<0,05) respectivamente, el consumo de oxígeno máximo pasó de 2.851±575 ml/min a 3.220±569 (p<0,001) en severos y de 2.199±727 a 2.330±678 en moderados (p<0,05), el consumo de oxígeno en el umbral anaerobio de 1.647±277 ml/min a 2.012±328 (p<0,001) y de 1.316±489 a 1.432±602 (p<0,05) respectivamente, y la ventilación minuto máxima de 85,83±19 litros a 92,25±22 (p<0,05) en los severos, no siendo significativa en los moderados. La PaO2 aumentó de 84,87±8,4 a 93,31±6,5 (p<0,05) en severos y de 79,97±8,6 a 87,8±8,1 (p<0,001) en moderados, la PaCO2 disminuyó de 43,33±2,1 a 40,77±2,7 (p<0,05) y de 44,38±3,5 a 42,73±3,4 (p<0,05) respectivamente, la hemoglobina lo hizo en un 8,41% (p<0,001) en los severos y el hematocrito en un 3,55% (p<0,001) en los severos. No hemos encontrado correlaciones lineales entre los parámetros de severidad del SAOS y los deterioros y mejorías objetivadas. CONCLUSIONES: En los pacientes estudiados, tras un mes de tratamiento con CPAP, mejoraron su rendimiento físico, pero ninguno de los parámetros ergométricos se correlacionó con la gravedad del SAOS (AU)

OBJECTIVES: to determine if Sleep Apnea-Hypopnea Syndrome (SAHS) is a cause of low physical performance, if physical performance is improved with nasal CPAP treatment and to study if there is a relationship between deterioration in physical performance and increased severity parameters of SAHS . METHODS: we conducted 32 patients diagnosed with SAHS (24 patients with severe SAHS measured as an apnea-hypopnea index –AHI- of ? 50 and 8 with moderate SAHS with AHI between 27-49) to undergo an exercise test on a treadmill up to maximum force before and after 30 days of treatment with nasal CPAP. Blood samples were taken at each test (haemogram, proteinogram, arterial gasometry) and measure of oxygen consumption was registered, before and after treatment. RESULTS: patients with severe SAHS reached a maximum potential of 191,83 ± 54 Watts before and 215 ± 57 Watts after treatment (p<0.001), while moderate SAHS patients reached 136,75 ± 54 and 145,87 ± 65 (p<0.05) respectively. Maximun oxygen consumption ranged from 2.851 ± 575 ml/min to 3.220 ± 569 (p<0.001) in patients with severe SAHS and from 2.199± 727 ml/min to 2.330 ± 678 (p<0.05) in moderate SAHS patients. Oxygen consumption in the anaerobic threshold varied from 1,647±277 ml/min to 2,012±328 (p<0.001) and from 1,316±489 to 1,432±602 (p<0.05) respectively, and the maximum ventilation per minute from 85.83±19 litres to 92.25±22 (p<0.05) in the severe and with no significant change in the moderates. The PaO2 increased from 84.87±8.4 to 93.31±6.5 (p<0.05) in the severe and from 79.97±8.6 to 87.8±8.1 (p<0.001) in the moderates, the PaCO2 reduced from 43.33±2.1 to 40.77±2.7 (p<0.05) and from 44.38±3.5 to 42.73±3.4 (p<0.05) respectively, the haemoglobin was 8.41% (p<0.001) and the haematocrit 3.55% (p<0.001) in the severe. No lineal correlations were found between the SAHS severity parameters and the objective deteriorations and improvements. CONCLUSIONS: In our patients, after a month of treatment with CPAP, improvement in physical performance was observed, but no correlation between the the ergometric parameters and severity of SAHS was found (AU)