Areola size and jugulum nipple distance after bilateral mastectomy and breast reconstruction.

OBJECTIVE: The combination of a single pedicle local flap with tattooing for complete nipple areola complex (NAC) reconstruction is currently the most supported method. Although many technical descriptions of NAC reconstruction exist in the medical literature, there are no data that define the ideal areola size (diameter of the areola) after bilateral mastectomy and breast reconstruction considering the previous areola size. METHODS: This was a 3-year (2009-2012) observational, analytical, and longitudinal prospective study with 103 patients who had undergone NAC tattooing as the last process of bilateral breast reconstruction after surgery for breast cancer. Statistical differences in the areola size and the jugulum-nipple distance before mastectomy and after reconstruction were analyzed by paired Student t tests with a 95% confidence interval. RESULTS: The jugulum-nipple distance before mastectomy was 4.23 cm larger than after bilateral reconstruction (mean jugulum-nipple distance: 23.89 cm vs 19.66 cm), and for that reason shorter (more cephalad). The areola size before mastectomy was 1.59 cm larger than the one chosen by the patient for reconstruction (mean diameter of the areola: 5.25 cm vs 3.65 cm). CONCLUSIONS: We conclude that, after bilateral mastectomy and reconstruction, the jugulum-nipple distance is smaller and women prefer smaller areola sizes.

Serum albumin levels in burn people are associated to the total body surface burned and the length of hospital stay but not to the initiation of the oral/enteral nutrition.

OBJECTIVE: Serum albumin levels have been used to evaluate the severity of the burns and the nutrition protein status in burn people, specifically in the response of the burn patient to the nutrition. Although it hasn't been proven if all these associations are fully funded. The aim of this retrospective study was to determine the relationship of serum albumin levels at 3-7 days after the burn injury, with the total body surface area burned (TBSA), the length of hospital stay (LHS) and the initiation of the oral/enteral nutrition (IOEN). SUBJECT AND METHODS: It was carried out with the health records of patients that accomplished the inclusion criteria and were admitted to the burn units at the University Hospital of Reina Sofia (Córdoba, Spain) and UAB Hospital at Birmingham (Alabama, USA) over a 10 years period, between January 2000 and December 2009. We studied the statistical association of serum albumin levels with the TBSA, LHS and IOEN by ANOVA one way test. The confidence interval chosen for statistical differences was 95%. Duncan's test was used to determine the number of statistically significantly groups. RESULTS: Were expressed as mean±standard deviation. We found serum albumin levels association with TBSA and LHS, with greater to lesser serum albumin levels found associated to lesser to greater TBSA and LHS. We didn't find statistical association with IOEN. CONCLUSION: We conclude that serum albumin levels aren't a nutritional marker in burn people although they could be used as a simple clinical tool to identify the severity of the burn wounds represented by the total body surface area burned and the lenght of hospital stay.

The potential association of later initiation of oral/enteral nutrition on euthyroid sick syndrome in burn patients.

Objective. The aim of this study was to determine if early initiation of oral/enteral nutrition in burn patients minimizes the drop in fT3 levels, reduces the potential for euthyroid sick syndrome (ESS), and shortens the length of hospital stay (LHS). Subjects and Methods. We retrospectively evaluated the statistical association of serum fT3, fT4, and TSH at the first (2nd-5th day) and second sample collection (9th-12th day) after the burn injury in 152 burn patients. Three groups were established depending on time of initiation of the oral/enteral nutrition: <24 h before the injury (Group 1), 24-48 h after the injury (Group 2), and >48 h after the injury (Group 3). Results. They were expressed as mean ± standard deviation. We found that LHS and the fT3 levels were statistically different in the 3 groups. The LHS (in days) was, respectively, in each group, 16.77 ± 4.56, 21.98 ± 4.86, and 26.06 ± 5.47. Despite the quantifiable drop in fT3, ESS was present only at the first sample collection (2.61 ± 0.92 days) in Group 3, but there was no group with ESS at the second sample collection (9.89 ± 1.01 days). Our data suggest that early initiation of nutritional supplementation decreases the length of hospitalization and is associated with decreasing fT3 serum concentration depression. Conclusion. Early initiation of oral/enteral nutrition counteracts ESS and improves the LHS in burn patients.

A new approach: resection and suture of orbicularis oculi muscle to define the upper eyelid fold and correct asymmetries.

UNLABELLED: Upper-eyelid blepharoplasty is a very common procedure in aesthetic plastic surgery. Among all the literature in favor of orbicularis muscle resection, there are no commentaries associated with orbicularis muscle suture and its convenience. This article discusses a new approach: independent resection of the orbicularis oculi muscle similar in size to the resected skin and the subsequent suture of the orbicularis muscle after its resection. This results in a fine reconstruction of the upper-eyelid crease, achieves a good definition of this anatomical structure, and allows correction of asymmetries with the contralateral upper eyelid. The results obtained (98 % of patients satisfied) and no complications with this procedure make it a safe alternative for upper blepharoplasty. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

[Skin graft, smoking and diabetes mellitus type 2]. / Injertos cutáneos, hábito de fumar y diabetes mellitus tipo 2.

Smoking and hyperglycemia decrease the success of skin graft survival in specific circumstances. It is well known that smoking and diabetes mellitus (DM) type 2 increase the oxidative and impair the endothelial function. The objective of this retrospective study was to determine if smoking and DM type 2 are factors associated with lower skin graft survival, in different etiologies of the injury associated to the skin loss. It was a bicentric, retrospective, cross sectional case control study, carried out on 2457 medical patients who met the inclusion criteria. It was carried out over a 10 years period between January 2000-December 2009, at Reina Sofía University Hospital (Córdoba, Spain) and UAB Hospital at Birmingham (Alabama, USA). The percentage of successful graft for each group and its control were analyzed by Chi-square test. The confidence interval chosen for statistical differences was 95%. Smoking and DM type 2 decreased the percentage of skin graft survival when compared with their control groups. DM type 2 was associated with greater negative success on skin graft survival than smoking when compared with their control groups. There was a statistically significant drop in skin graft of 18% in smoking group (range: 68-86%) and 25% in DM type 2 group (53-78%). The OR showed a clear association between the risk factors studied and the lower skin graft success, being stronger for DM type 2. In conclusion, DM type 2 and smoking are factors associated to lower skin graft take.

Injertos cutáneos, hábito de fumar y diabetes mellitus tipo 2 / Skin graft, smoking and diabetes mellitus type 2

El tabaco y la hiperglucemia reducen significativamente el éxito de los injertos cutáneos. El estrés oxidativo y la disfunción endotelial son factores que se asocian tanto al tabaquismo como a la diabetes mellitus (DM) tipo 2. El objetivo de este estudio fue constatar si existe una asociación entre estos factores de riesgo y el descenso en el porcentaje de éxito de los injertos en pérdidas cutáneas de diversa etiología. Estudio bicéntrico, retrospectivo, de casos y controles, llevado a cabo de enero 2000 a diciembre 2009, en los centros hospitalarios de Reina Sofía (Córdoba, España) y Birmingham (Alabama, EE.UU.), con 2457 pacientes que cumplían los criterios de inclusión. El éxito del injerto p ara cada grupo fue analizado mediante chi-cuadrado. El intervalo de confianza fue del 95%. El hábito de fumar y la DM tipo 2 disminuyeron el porcentaje de éxito de los injertos comparados con sus grupos controles, siendo el efecto de la DM tipo 2 mayor que el del tabaco. Se observó un descenso altamente significativo del porcentaje de injertos prendidos, del 18% en el grupo de fumadores (de 86% a 68%), y del 25% en el grupo de los diabéticos (de 78% a 53%). El cálculo de OR demostró asociación entre los factores de riesgo estudiados y el menor éxito de los injertos cutáneos, siendo mayor para la DM tipo 2. En conclusión: la DM tipo 2 y el hábito de fumar son factores que influyen negativamente en el éxito de los injertos cutáneos.

Smoking and hyperglycemia decrease the success of skin graft survival in specific circumstances. It is well known that smoking and diabetes mellitus (DM) type 2 increase the oxidative and impair the endothelial function. The objective of this retrospective study was to determine if smoking and DM type 2 are factors associated with lower skin graft survival, in different etiologies of the injury associated to the skin loss. It was a bicentric, retrospective, cross sectional case control study, carried out on 2457 medical patients who met the inclusion criteria. It was carried out over a 10 years period between January 2000-December 2009, at Reina Sofía University Hospital (Córdoba, Spain) and UAB Hospital at Birmingham (Alabama, USA). The percentage of successful graft for each group and its control were analyzed by Chi-square test. The confidence interval chosen for statistical differences was 95%. Smoking and DM type 2 decreased the percentage of skin graft survival when compared with their control groups. DM type 2 was associated with greater negative success on skin graft survival than smoking when compared with their control groups.. There was a statistically significant drop in skin graft of 18% in smoking group (range: 68-86%) and 25% in DM type 2 group (53-78%). The OR showed a clear association between the risk factors studied and the lower skin graft success, being stronger for DM type 2. In conclusion, DM type 2 and smoking are factors associated to lower skin graft take.

Injertos cutáneos, hábito de fumar y diabetes mellitus tipo 2 / Skin graft, smoking and diabetes mellitus type 2

El tabaco y la hiperglucemia reducen significativamente el éxito de los injertos cutáneos. El estrés oxidativo y la disfunción endotelial son factores que se asocian tanto al tabaquismo como a la diabetes mellitus (DM) tipo 2. El objetivo de este estudio fue constatar si existe una asociación entre estos factores de riesgo y el descenso en el porcentaje de éxito de los injertos en pérdidas cutáneas de diversa etiología. Estudio bicéntrico, retrospectivo, de casos y controles, llevado a cabo de enero 2000 a diciembre 2009, en los centros hospitalarios de Reina Sofía (Córdoba, España) y Birmingham (Alabama, EE.UU.), con 2457 pacientes que cumplían los criterios de inclusión. El éxito del injerto p ara cada grupo fue analizado mediante chi-cuadrado. El intervalo de confianza fue del 95%. El hábito de fumar y la DM tipo 2 disminuyeron el porcentaje de éxito de los injertos comparados con sus grupos controles, siendo el efecto de la DM tipo 2 mayor que el del tabaco. Se observó un descenso altamente significativo del porcentaje de injertos prendidos, del 18% en el grupo de fumadores (de 86% a 68%), y del 25% en el grupo de los diabéticos (de 78% a 53%). El cálculo de OR demostró asociación entre los factores de riesgo estudiados y el menor éxito de los injertos cutáneos, siendo mayor para la DM tipo 2. En conclusión: la DM tipo 2 y el hábito de fumar son factores que influyen negativamente en el éxito de los injertos cutáneos.(AU)

Smoking and hyperglycemia decrease the success of skin graft survival in specific circumstances. It is well known that smoking and diabetes mellitus (DM) type 2 increase the oxidative and impair the endothelial function. The objective of this retrospective study was to determine if smoking and DM type 2 are factors associated with lower skin graft survival, in different etiologies of the injury associated to the skin loss. It was a bicentric, retrospective, cross sectional case control study, carried out on 2457 medical patients who met the inclusion criteria. It was carried out over a 10 years period between January 2000-December 2009, at Reina Sofía University Hospital (Córdoba, Spain) and UAB Hospital at Birmingham (Alabama, USA). The percentage of successful graft for each group and its control were analyzed by Chi-square test. The confidence interval chosen for statistical differences was 95%. Smoking and DM type 2 decreased the percentage of skin graft survival when compared with their control groups. DM type 2 was associated with greater negative success on skin graft survival than smoking when compared with their control groups.. There was a statistically significant drop in skin graft of 18% in smoking group (range: 68-86%) and 25% in DM type 2 group (53-78%). The OR showed a clear association between the risk factors studied and the lower skin graft success, being stronger for DM type 2. In conclusion, DM type 2 and smoking are factors associated to lower skin graft take.(AU)

Giant earlobe epidermoid cyst.

Epidermoid cysts represent the most common cutaneous cysts. They are usually small and benign; however, sometimes they can grow to giant epidermoid cists, and occasionally malignancies develop. Giant epidermoid cysts at the earlobe have never been described but in other locations. We describe a case of a giant epidermoid cyst at the earlobe, a location where such a large cyst has never been reported before. The mass was completely resected and the wound of the pedunculated base was sutured with four stitches of nylon 5/0. Histopathology confirmed the presumptive diagnosis of an epidermoid cyst. Six months after the resection, the patient did not have any relapse of the epidermoid cyst. The earlobe is a potential location for giant epidermoid cysts. Although the clinical diagnosis could be enough, due to the possibility of malignancy and to ensure appropriate diagnosis, we consider that all cysts should be sent to the anatomic pathology laboratory for histological evaluation.

Clinical evaluation of the nose: a cheap and effective tool for the nasal fracture diagnosis.

OBJECTIVE: An accurate diagnosis of nasal fracture is dependent on a thorough history and physical examination. The purpose of this investigation was to create a simple method to establish the diagnosis of nasal fracture based only on clinical criteria. METHODS: A retrospective chart review was carried out of 220 patients suspected of nasal fracture admitted to a hospital specializing in occupational injuries in 2003 and 2004. Sensitivity, specificity, and positive/negative predictive value (PPV/NPV) were calculated for each clinical criterion (8), all the possible combinations of 2 clinical criteria (28) and 3 clinical criteria (56). The following clinical criteria were considered for the analysis: epistaxis, periorbital and/or perinasal ecchymosis, nasal wound or laceration, airway obstruction, nasal inflammation, lateral deviation, irregular nasal dorsum, and acute septal injury. Logisitic regression was used to assess statistical significance. RESULTS: For any of the 8 criteria, the average sensitivity and negative predictive values for nasal fracture were very low (<35%). However, specificity and positive predictive values were relatively high (>90%) and increased, respectively, when at least 1 criterion was present (92% and 94%, respectively), when 2 clinical criteria were present (98% and 96%, respectively), and when at least 3 clinical criteria were present (100% for both). CONCLUSIONS: The presentation of the clinical criteria can be a valuable method for the diagnoses of nasal fracture; nevertheless, when these clinical criteria are absent, the possibility of the nasal fracture cannot be ruled out though the possibility is remote.

Smoking and diabetes mellitus type 2 reduce skin graft take; the use of fibrin glue might restore graft take to optimal levels.

Efficacy has been demonstrated in some uses of fibrin glue associated with graft loss. Smoking and hyperglycemia significantly decrease the success of skin graft survival in specific injuries. This retrospective study aimed to verify the association with decreased skin graft survival and whether fibrin glue is useful in reversing the influence of these factors. This bicentric, retrospective, cross sectional case control study was carried out on 1881 medical patients. Patients who met inclusion criteria were admitted to the Plastic Surgery Service of Reina Sofia University Hospital (Spain) and the Trauma/Burn intensive Care Unit of UAB Hospital at Birmingham (USA) between January 2000 and December 2009. The successful graft take for each group and its control were analyzed by a Chi-square test; the confidence interval was 95%. Smoking and DM type 2 decrease skin graft survival when compared with their control groups. There was a statistically significant improvement in skin graft take when fibrin glue was used. The percentage improvement in the control groups was approximately 10%, whereas in the study groups it was 2-3 times higher. We conclude that graft loss is associated with smoking and DM type 2, but fibrin glue might restore graft adherence to almost normal levels.

Chondromucosal nasal flap with the transposition flap of von langenbeck as a good election for the total lower eyelid defect reconstruction in an old patient with an elevated vision loss in the contralateral eye.

OBJECTIVE: The management of lower eyelid reconstruction has a variety of treatment strategies with varying success depending on the patient. We tried to apply the most suitable reconstruction techniques for this particular case. METHODS: We report a case of a 99-year-old woman, with a vision loss of 70% in the left eye and 40% in the right eye, who underwent basal cell carcinoma resection of the lower right eyelid 3 months before. The margins of resection and the deepest layers were affected. After the histopathology report, we decided to plan a more aggressive treatment with a total resection of the lower right eyelid. We had a case with 3 added difficulties: the old age of the patient, the vision loss in the contralateral eye, and the size of the resection. RESULTS: On the basis of our experience and the bibliography reviewed, we decided to use the chondromucosal nasal flap for the posterior lamella reconstruction and the transposition flap of von Langenbeck for the anterior lamella. We found it was a good election for this patient since we achieved good functional, anatomical, and aesthetical results with a one-step operation. CONCLUSIONS: The chondromucosal nasal flap with the transposition flap of von Langenbeck was a good election for a total lower eyelid defect reconstruction in an old patient with a high vision loss in the contralateral eye.

The effect of the Spanish Ketogenic Mediterranean Diet on nonalcoholic fatty liver disease: a pilot study.

The "Spanish Ketogenic Mediterranean Diet" (SKMD) has been shown to be an effective and safe way to cure patients suffering from metabolic syndrome (MS). Keeping in mind that nonalcoholic fatty liver disease (NAFLD) is closely associated with MS, the purpose of this study was to evaluate the potential therapeutic properties under free living conditions of the SKMD in patients with MS (following the International Diabetes Federation [IDF] consensus guidelines) and NAFLD (suspected by using a cutoff value of alanine aminotransferase [ALT] levels of >40 U/L and confirmed by abdominal ultrasonography) over a 12-week period. A prospective study was carried out in 14 obese men meeting the inclusion criteria and whose body mass index (BMI) and age were 36.58±0.54 kg/m² and 41.18±2.28 years, respectively. Statistical differences between the parameters studied before and after administration of the SKMD (week 0 and 12) were analyzed by paired Student's t test (continuous variables) and the χ² test (discontinuous variables). P<.05 was considered statistically significant. There was an extremely significant (P<.001) improvement in body weight (from 109.79 kg to 95.86 kg), low-density lipoprotein-cholesterol (from 123.43 mg/dL to 100.35 mg/dL), ALT (from 71.92 U/L to 37.07 U/L), aspartate aminotransferase (from 47.71 U/L to 29.57 U/L), steatosis degree (complete fatty liver regression was observed in 21.4% of the patients, and an overall reduction was found in 92.86% of the patients), and all the parameters studied associated with the MS: BMI (from 36.99 kg/m² to 32.42 kg/m²), waist circumference (from 114.01 cm to 98.59 cm), fasting plasma glucose (from 118.57 mg/dL to 90.14 mg/dL), triacylglycerols (from 232.64 mg/dL to 111.21 mg/dL), high-density lipoprotein-cholesterol (HDLc) (from 42.81 mg/dL to 58.71 mg/dL), systolic blood pressure (from 142.86 mm Hg to 125.36 mm Hg), and diastolic blood pressure (from 89.64 mm Hg to 77.86 mm Hg). After the diet all the subjects were free of MS according to the IDF definition, and 100% of them had normal triacylglycerols and HDLc levels, in spite of the fact that 100% of them still had a BMI of >30 kg/m². We conclude that the SKMD could be an effective and safe way to treat patients suffering from MS and the associated NAFLD.

Role of citrus juices and distinctive components in the modulation of degenerative processes: genotoxicity, antigenotoxicity, cytotoxicity, and longevity in Drosophila.

It is well established that breakfast beverages contain high quantities of Citrus juices. The purpose of the present study was to assess the nutraceutical value of orange and lemon juices as well as two of their active compounds: hesperidin and limonene. Indicator assays were performed at three levels to evaluate different biological health promoter activities: (i) determination of the safety and DNA-damage protecting ability against free radicals by using the somatic mutation and recombination test (SMART) in Drosophila melanogaster, (ii) study of the modulating role for life span in Drosophila melanogaster, and (iii) measurement of the cytotoxic activity against the human tumor cell line HL60. The highest concentrations assayed for lemon juice and limonene (50% v/v and 0.73 mM, respectively) showed genotoxic activity as evidenced from SMART. Orange and lemon juices as well as hesperidin and limonene exhibit antigenotoxic activity against hydrogen peroxide used as an oxidative genotoxin. Life-span experiments revealed that the lower concentrations of orange juice, hesperidin, and limonene exerted a positive influence on the life span of Drosophila. Finally all substances showed cytotoxic activity, with hesperidin being least active. Taking into account the safety, antigenotoxicity, longevity, and cytotoxicity data obtained in the different assays, orange juice may be a candidate as a nutraceutical food as it (1) is not genotoxic, (2) is able to protect DNA against free radicals, and (3) inhibits growth of tumor cells.

A pilot study of the Spanish Ketogenic Mediterranean Diet: an effective therapy for the metabolic syndrome.

The "Spanish Ketogenic Mediterranean Diet" (SKMD) has been shown to promote potential therapeutic properties for the metabolic syndrome. The purpose of this study was to evaluate the potential therapeutic properties under free-living conditions of the SKMD in patients with metabolic syndrome (following the International Diabetes Federation consensus guidelines) over a 12-week period. A prospective study was carried out in 22 obese subjects with metabolic syndrome (12 men and 10 women) with the inclusion criteria whose body mass index of 36.58 ± 0.54 kg/m² and age was 41.18 ± 2.28 years. Statistical differences between the parameters studied before and after the administration of the SKMD (week 0 and 12, respectively) were analyzed by paired Student's t test. There was an extremely significant (P < .001) improvement in low-density lipoprotein cholesterol (from 126.25 mg/dL to 103.87 mg/dL) and all the parameters studied associated with metabolic syndrome: body weight (from 106.41 kg to 91.95 kg), body mass index (from 36.58 kg/m² to 31.69 kg/m²), waist circumference (from 111.97 cm to 94.70 cm), fasting plasma glucose (from 118.81 mg/dL to 91.86 mg/dL), triacylglycerols (from 224.86 mg/dL to 109.59 mg/dL), high-density lipoprotein cholesterol (from 44.44 to 57.95 mg/dL), systolic blood pressure (from 141.59 mm Hg to 123.64 mm Hg), and diastolic blood pressure (from 89.09 mm Hg to 76.36 mm Hg). The most affected parameter was the triacylglycerols (51.26% reduction). After the diet all the subjects were free of metabolic syndrome according to the International Diabetes Federation definition, and 100% of them had normal triacylglycerols and high-density lipoprotein cholesterol levels, in spite of the fact that 77.27% of them still had a body mass index of > 30 kg/m². We conclude that the SKMD could be an effective and safe way to cure patients suffering from metabolic syndrome. Future research should include a larger sample size, a longer-term use, and a comparison with other ketogenic diets.

El deportista y el pH: importancia del lactato y la dieta / Sportsmen and pH: the importance of lactate and diet

No existe evidencia bioquímica clara para sostener que la producción de lactato cause acidosis, sino más bien todo lo contrario, ya que el lactato retrasa y no causa la aparición de dicha acidosis. Además de la manipulación previa a un evento deportivo de las condiciones ácido-básicas del medio interno, mediante el empleo de ayudas ergogénicas como pudiera ser el bicarbonato o el citrato sódico, los hábitos alimenticios del deportista también pueden desempeñar un papel importante. Como ejemplos claros tenemos el empleo de dietas cetogénicas y el de una alimentación rica en vegetales y frutas. En el primer caso, las dietas cetógenicas podrían ser de utilidad en actividades deportivas con predominio aeróbico, en detrimento de las que tienen un alto componente anaeróbico. En relación a una dieta equilibrada rica en vegetales y frutas, podría contrarrestar la acidosis metabólica subclínica derivada de una alta ingesta de productos de origen animal y alimentos con una alta carga glucémica como son los cereales y sus derivados. Esto contrarrestaría la pérdida de masa muscular y densidad ósea asociada a este proceso metabólico. Son necesarias más investigaciones que aporten datos contrastables sobre la verdadera influencia y peso de estos patrones alimenticios en la mejora del rendimiento del deportista(AU)

There is no clear biochemical evidence to support the notion that lactate production causes acidosis; on the contrary, lactate production delays rather than causes acidosis. In addition to manipulation of the internal acid-basic environment before a sporting event through the use of ergogenic aids such as sodium bicarbonate or citrate, the nutritional habits of sportsmen can also play an important role in modulating acidosis. Clear examples are the use of a ketogenic diet or a diet high in fruit and vegetables. Ketogenic diets may be useful in aerobic sporting activities but are detrimental in sporting activities with a high anaerobic component.A well-balanced diet high in fruit and vegetables can counteract subclinical metabolic acidosis due to a high intake of animal products or high-glycemic load foods such as cereals and related products, which could prevent the loss of muscle mass and bone density associated with this metabolic process. Further investigations are required to determine the real influence of these nutritional patterns in improving sporting performance(AU)

Citrulline malate enhances athletic anaerobic performance and relieves muscle soreness.

The purpose of the present study was to determine the effects of a single dose of citrulline malate (CM) on the performance of flat barbell bench presses as an anaerobic exercise and in terms of decreasing muscle soreness after exercise. Forty-one men performed 2 consecutive pectoral training session protocols (16 sets). The study was performed as a randomized, double-blind, 2-period crossover design. Eight grams of CM was used in 1 of the 2 training sessions, and a placebo was used in the other. The subjects' resistance was tested using the repetitions to fatigue test, at 80% of their predetermined 1 repetition maximum (RM), in the 8 sets of flat barbell bench presses during the pectoral training session (S1-4 and S1'-4'). The p-value was 0.05. The number of repetitions showed a significant increase from placebo treatment to CM treatment from the third set evaluated (p <0.0001). This increase was positively correlated with the number of sets, achieving 52.92% more repetitions and the 100% of response in the last set (S4'). A significant decrease of 40% in muscle soreness at 24 hours and 48 hours after the pectoral training session and a higher percentage response than 90% was achieved with CM supplementation. The only side effect reported was a feeling of stomach discomfort in 14.63% of the subjects. We conclude that the use of CM might be useful to increase athletic performance in high-intensity anaerobic exercises with short rest times and to relieve postexercise muscle soreness. Thus, athletes undergoing intensive preparation involving a high level of training or in competitive events might profit from CM.

Rendimiento deportivo: Composición corporal, peso, energía-macronutrientes y digestión (II) / Athletic perfomance: Body composition, weight, energy-macronutrients and digestion (II)

El texto se podría resumir en los siguientes puntos: – La presencia de grasa corporal en el atleta es necesaria, ya que un bajo porcentaje de grasa corporal se asocia a un deterioro en la salud y el rendimiento deportivo.– Ganar peso demasiado rápido tiene el inconveniente de que el 60-70% de la ganancia es grasa. – Tener un óptimo aporte energético beneficiará al atleta no sólo en su rendimiento deportivo, sino también en su perfil metabólico, salud, composición corporal y estética final. – Los niveles óptimos de hidratos de carbono y proteínas en el deportista dependen de la intensidad-frecuencia del ejercicio y oscilan entre 5 y 10 g/kg de peso y día para los primeros y 1-2 g/kg de peso y día para los segundos, siendo una de las mejores opciones proteicas la combinación suero de leche-caseína. En relación a la grasa, se recomienda consumir al menos 0,5-1 g/kg de peso y día, haciéndolo de forma isocalórica y evitando las grasas trans. – En la ingesta de soluciones enriquecidas con electrolitos y carbohidratos, el nivel óptimo de hidratos de carbono es del 5-7%, siendo poco influyente el nivel de electrolitos presente y una buena opción el empleo de la sacarosa o azúcar de mesa (AU)

The following points summarize the text: – Too little body fat results in deterioration of health and performance and can be associated with eating disorders.– The nutritional strategy to promote fat-free muscle gain in a short time is not the most suitable since 60-70% of the weight gained is fat. – To intake enough calories will help the athletes in their performance, metabolic basal rate, health, body composition and final aesthetic body. – In terms of carbohydrate and protein needs, athletes need to consume 5-10 g/kg of carbohydrates and 1-2 g/kg of proteins per day (the combination of whey and casein protein is one of the best options), in order to guarantee the recovery. These quantities will depend on the volume and frequency training protocol. In relation to fat intake, it has been recommended to consume at least 0.5-1g/kg per day and under isocaloric proportions distributed among saturated, monounsaturated, and polyunsaturated fat (avoiding trans fats). – For the gastric emptying and the intestinal absorption, the most important characteristic of a fluid replacement beverage during as port session, is the carbohydrates and not the electrolytes concentration. A solution containing 5-7% carbohydrate might be considered optimal and the sucrose (saccharose or table sugar) would be a good option (AU)

Rendimiento deportivo: Composición corporal, peso, energía-macronutrientes y digestión (I) / Athletic perfomance: body composition, weight, energy-macronutrients and digestion (I)

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Las dietas cetogénicas: beneficios adicionales a la pérdida de peso y efectos secundarios infundados: [revisión] / Ketogenic diets: additional benefits to the weight loss and unfounded secondary effects: [review]

Además de la pérdida de peso, también es importante enfatizar que las dietas cetogénicas son saludables cardiovascularmente y para el metabolismo glucídico, ya que promueven un perfil lipídico no aterogénico, el descenso de la presión arterial y disminuyen la resistencia a la insulina con una mejora en los niveles plasmáticos de glucosa e insulina. Estas dietas podrían tener efectos anticancerígenos, no tienen efectos perniciosos sobre el hígado o el riñón, no se asocian a acidosis metabólica, tienen muchas propiedades beneficiosas sobre el sistema nervioso central, no producen osteoporosis y podrían aumentar el rendimiento en la actividad deportiva de tipo aeróbico.

Ketogenic diets: additional benefits to the weight loss and unfounded secondary effects. It is also necessary to emphasise that as well as the weight loss, ketogenic diets are healthier because they promote a non-atherogenic lipid profile, lower blood pressure and diminish resistance to insulin with an improvement in blood levels of glucose and insulin. Such diets also have antineoplasic benefits, do not alter renal or liver functions, do not produce metabolic acidosis by Ketosis, have many neurological benefits in central nervous system, do not produce osteoporosis and could increase the perfomance in aerobic sports.