Trasplante autólogo de progenitores hematopoyéticos en paciente con enfermedad de Crohn refractaria / Autologous hematopoietic stem cell transplantation in a patient with refractory Crohn’s disease

La enfermedad de Crohn es una condición crónica para la que en ocasiones no existe tratamiento efectivo, ni médi-co ni quirúrgico. En estos casos, el trasplante autólogo de progenitores hematopoyéticos puede ser una opción tera-péutica con la que restaurar la tolerancia inmunológica del paciente. En algunos casos se conseguirá la remisión de la enfermedad o un descenso en su actividad, haciendo que fármacos que habían fracasado vuelvan a ser efectivos. El perfil de seguridad del procedimiento, unido al hecho de que no es un tratamiento curativo, hace que la selección de los pacientes tenga que ser muy rigurosa.Presentamos nuestra experiencia con el primer pacien-te seleccionado en nuestro centro para trasplante autólogo de progenitores hematopoyéticos: un varón de 27 años con enfermedad de Crohn (A1L3B1p) refractaria a múltiples líneas de tratamiento médico y no candidato a tratamien-to quirúrgico, que dos años tras el trasplante se encuentra asintomático (AU)

Crohn’s disease is a chronic condition for which some-times there is no effective medical or surgical treatment. Autologous hematopoietic stem cell transplantation may be a therapeutic option for these patients to restore immune tolerance. Consequently, this may lead to remission of the disease or decrease its activity, making drugs that have pre-viously failed be effective. Due to the safety profile of the procedure and the fact that it is a non-curative treatment, patient selection must be rigorous.We report our experience with the first patient se-lected in our centre for autologous hematopoietic stem cell transplantation: 27 years old male with Crohn’s dis-ease (A1L3B1p) refractory to multiple lines of medical treatment and not a candidate for surgical treatment. Two years after the transplantation, the patient remains asymptomatic (AU)

[Autologous hematopoietic stem cell transplantation in a patient with refractory Crohn's disease].

Crohn's disease is a chronic condition for which sometimes there is no effective medical or surgical treatment. Autologous hematopoietic stem cell transplantation may be a therapeutic option for these patients to restore immune tolerance. Consequently, this may lead to remission of the disease or decrease its activity, making drugs that have previously failed be effective. Due to the safety profile of the procedure and the fact that it is a non-curative treatment, patient selection must be rigorous. We report our experience with the first patient selected in our centre for autologous hematopoietic stem cell transplantation: 27 years old male with Crohn's disease (A1L3B1p) refractory to multiple lines of medical treatment and not a candidate for surgical treatment. Two years after the transplantation, the patient remains asymptomatic.

Effectiveness and Safety of Ustekinumab in Elderly Patients with Crohn's Disease: Real World Evidence From the ENEIDA Registry.

BACKGROUND AND AIMS: Clinical trials and real-life studies with ustekinumab in Crohn's disease [CD] have revealed a good efficacy and safety profile. However, these data are scarcely available in elderly patients. Therefore, we aim to assess the effectiveness and safety of ustekinumab in elderly patients with CD. METHODS: Elderly patients [>60 years old] from the prospectively maintained ENEIDA registry treated with ustekinumab due to CD were included. Every patient was matched with two controls under 60 years of age, according to anti-tumour necrosis factor use and smoking habit. Values for the Harvey-Bradshaw Index [HBI], endoscopic activity, C-reactive protein [CRP] and faecal calprotectin [FC] were recorded at baseline and at weeks 16, 32 and 54. RESULTS: In total, 648 patients were included, 212 of whom were elderly. Effectiveness was similar between young and elderly patients during the follow-up. Steroid-free remission was similar at week 16 [54.6 vs 51.4%, p = 0.20], 32 [53.0% vs 54.5%, p = 0.26] and 54 [57.8% vs 51.1%, p = 0.21]. Persistence of ustekinumab as maintenance therapy was similar in both age groups [log-rank test; p = 0.91]. There was no difference in the rate of adverse effects [14.2% vs 11.2%, p = 0.350], including severe infections [7.1% vs 7.3%, p = 1.00], except for the occurrence of de novo neoplasms, which was higher in older patients [0.7% vs 4.3%, p = 0.003]. CONCLUSIONS: Ustekinumab is as effective in elderly patients with CD as it is in non-elderly patients. The safety profile also seems to be similar except for a higher rate of de novo neoplasms, probably related to the age of the elderly patients.

Risk Factors for COVID-19 in Inflammatory Bowel Disease: A National, ENEIDA-Based Case-Control Study (COVID-19-EII).

(1) Scant information is available concerning the characteristics that may favour the acquisition of COVID-19 in patients with inflammatory bowel disease (IBD). Therefore, the aim of this study was to assess these differences between infected and noninfected patients with IBD. (2) This nationwide case−control study evaluated patients with inflammatory bowel disease with COVID-19 (cases) and without COVID-19 (controls) during the period March−July 2020 included in the ENEIDA of GETECCU. (3) A total of 496 cases and 964 controls from 73 Spanish centres were included. No differences were found in the basal characteristics between cases and controls. Cases had higher comorbidity Charlson scores (24% vs. 19%; p = 0.02) and occupational risk (28% vs. 10.5%; p < 0.0001) more frequently than did controls. Lockdown was the only protective measure against COVID-19 (50% vs. 70%; p < 0.0001). No differences were found in the use of systemic steroids, immunosuppressants or biologics between cases and controls. Cases were more often treated with 5-aminosalicylates (42% vs. 34%; p = 0.003). Having a moderate Charlson score (OR: 2.7; 95%CI: 1.3−5.9), occupational risk (OR: 2.9; 95%CI: 1.8−4.4) and the use of 5-aminosalicylates (OR: 1.7; 95%CI: 1.2−2.5) were factors for COVID-19. The strict lockdown was the only protective factor (OR: 0.1; 95%CI: 0.09−0.2). (4) Comorbidities and occupational exposure are the most relevant factors for COVID-19 in patients with IBD. The risk of COVID-19 seems not to be increased by immunosuppressants or biologics, with a potential effect of 5-aminosalicylates, which should be investigated further and interpreted with caution.

Nationwide COVID-19-EII Study: Incidence, Environmental Risk Factors and Long-Term Follow-Up of Patients with Inflammatory Bowel Disease and COVID-19 of the ENEIDA Registry.

We aim to describe the incidence and source of contagion of COVID-19 in patients with IBD, as well as the risk factors for a severe course and long-term sequelae. This is a prospective observational study of IBD and COVID-19 included in the ENEIDA registry (53,682 from 73 centres) between March-July 2020 followed-up for 12 months. Results were compared with data of the general population (National Centre of Epidemiology and Catalonia). A total of 482 patients with COVID-19 were identified. Twenty-eight percent were infected in the work environment, and 48% were infected by intrafamilial transmission, despite having good adherence to lockdown. Thirty-five percent required hospitalization, 7.9% had severe COVID-19 and 3.7% died. Similar data were reported in the general population (hospitalisation 19.5%, ICU 2.1% and mortality 4.6%). Factors related to death and severe COVID-19 were being aged ≥ 60 years (OR 7.1, 95% CI: 1.8-27 and 4.5, 95% CI: 1.3-15.9), while having ≥2 comorbidities increased mortality (OR 3.9, 95% CI: 1.3-11.6). None of the drugs for IBD were related to severe COVID-19. Immunosuppression was definitively stopped in 1% of patients at 12 months. The prognosis of COVID-19 in IBD, even in immunosuppressed patients, is similar to that in the general population. Thus, there is no need for more strict protection measures in IBD.

Ustekinumab en enfermedad de Crohn: efectividad y seguridad en práctica clínica / Ustekinumab in Crohn's disease: effectiveness and safety in clinical practice

INTRODUCCIÓN: Ustekinumab (UST) es un anticuerpo monoclonal frente a IL-12/23 aprobado en España (2017) para tratar el brote moderado/grave de enfermedad de Crohn. OBJETIVO: Evaluar la efectividad y seguridad en práctica clínica real en los pacientes tratados con UST en nuestro centro. MÉTODOS: Estudio prospectivo observacional unicéntrico incluyendo los pacientes que iniciaron UST desde el 1/08/2017 hasta el 28/02/2019 con seguimiento hasta esa fecha. Analizamos respuesta y remisión en semanas 16, 24 y 52, utilizando «Crohn's Disease Activity Index» (respuesta si descenso de 100 puntos y remisión si <150) y la «Valoración Global del especialista» traducción del «Physician's Global Assessment». RESULTADOS: Incluimos 61 pacientes con una mediana de duración de enfermedad de Crohn de 14,6 años (0-36). El 83,6% sin esteroides y el 73,8% sin inmunosupresores asociados. Previamente todos habían recibido anti-TNF y el 14,8%, además, vedolizumab. Observamos buena correlación entre Crohn's Disease Activity Index y Valoración Global del especialista (r = 0,89, p < 0,001). En la semana 16 (n = 45) un 75,6% de respuesta (57,8% remisión), en semana 24 (n = 35) 69,9% respuesta (45,7% remisión) y en semana 52 (n = 12) 75% respuesta (58,3% remisión). No se obtuvieron diferencias estadísticamente significativas en la tasa de respuesta/remisión en semana 16 ni 24 en función del motivo de inicio de UST o el número de biológicos previos. En 2 pacientes se retiró por toxicidad (artralgias/mialgias). CONCLUSIÓN: UST es un fármaco eficaz y seguro en práctica clínica real con altas tasas de remisión clínica en semana 16, 24 y 52 independientemente del orden de biológico utilizado y del motivo de inicio de UST

INTRODUCTION: Ustekinumab (UST) is a monoclonal antibody against IL-12/23 approved in Spain (2017) to treat moderate / severe Crohn's disease. OBJECTIVE: To evaluate the effectiveness and safety in real clinical practice in patients treated with UST in our center. METHODS: This is a prospective observational study including patients who started UST from 08/01/2017 to 02/28/2019 with follow-up up to that date. We analyze response and remission in weeks 16, 24 and 52, using "Crohn's Disease Activity Index" (response if 100 point decrease and remission if <150) and Physician's Global Assessment. RESULTS: We included 61 patients with a median duration of Crohn's disease of 14,6 years (0-36). The 83,6% of patients without steroids and 73,8% without associated immunosuppressors. Previously all patients had received anti-TNF and 14,8%, in addition, vedolizumab. We observed a good correlation between Crohn's Disease Activity Index and Physician's Global Assessment (r = 0,89, p <.001). In week 16 (n = 45) 75,6% response (57,8% remission), in week 24 (n = 35) 69,9% response (45,7% remission) and in week 52 (n = 12) 75% response (58.3% remission). There were no statistically significant differences in the response/remission rates at week 16 or 24 depending on the reason for the onset of UST or the number of previous biologics. In 2 patients it was withdrawn due to toxicity (arthralgia / myalgia). CONCLUSION: UST is an effective and safe treatment in real clinical practice with high rates of clinical remission at week 16, 24 and 52 regardless of the order of biological used and the reason for starting UST

Neutropenia por linfocitos grandes granulares secundaria a adalimumab y reactivación de mononucleosis: reporte de un caso y revisión de la literatura / Neutropenia induced by large granular lymphocytes secondary to adalimumab and reactivated mononucleosis: case report and literature review

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Ustekinumab in Crohn's disease: effectiveness and safety in clinical practice. / Ustekinumab en enfermedad de Crohn: efectividad y seguridad en práctica clínica.

INTRODUCTION: Ustekinumab (UST) is a monoclonal antibody against IL-12/23 approved in Spain (2017) to treat moderate / severe Crohn's disease. OBJECTIVE: To evaluate the effectiveness and safety in real clinical practice in patients treated with UST in our center. METHODS: This is a prospective observational study including patients who started UST from 08/01/2017 to 02/28/2019 with follow-up up to that date. We analyze response and remission in weeks 16, 24 and 52, using "Crohn's Disease Activity Index" (response if 100 point decrease and remission if <150) and Physician's Global Assessment. RESULTS: We included 61 patients with a median duration of Crohn's disease of 14,6 years (0-36). The 83,6% of patients without steroids and 73,8% without associated immunosuppressors. Previously all patients had received anti-TNF and 14,8%, in addition, vedolizumab. We observed a good correlation between Crohn's Disease Activity Index and Physician's Global Assessment (r = 0,89, p <.001). In week 16 (n = 45) 75,6% response (57,8% remission), in week 24 (n = 35) 69,9% response (45,7% remission) and in week 52 (n = 12) 75% response (58.3% remission). There were no statistically significant differences in the response/remission rates at week 16 or 24 depending on the reason for the onset of UST or the number of previous biologics. In 2 patients it was withdrawn due to toxicity (arthralgia / myalgia). CONCLUSION: UST is an effective and safe treatment in real clinical practice with high rates of clinical remission at week 16, 24 and 52 regardless of the order of biological used and the reason for starting UST.

Utilidad clínica de la determinación de niveles de CT-P13, biosimilar de infliximab, en el control de la enfermedad inflamatoria intestinal / Clinical value of CT-P13 trough levels, an infliximab biosimilar, in the management of inflammatory bowel disease

INTRODUCCIÓN: CT-P13 es un fármaco biosimilar de infliximab (IFX), efectivo en pacientes con enfermedad inflamatoria intestinal (EII). La medición de niveles de IFX y anticuerpos anti-IFX forma parte del tratamiento integral de dicha enfermedad. OBJETIVO: Comparar la respuesta clínica en función de un abordaje estrictamente clínico (CLN) o proactivo (PRO) basado en la medición de niveles en la semana 14, en la práctica clínica. MÉTODOS: Estudio prospectivo en pacientes que inician CT-P13 por EII. En el grupo PRO se midieron sistemáticamente los niveles de IFX y de anticuerpos postinducción (semana 14) y se intensificaron aquellos con niveles infraterapéuticos (<3μg/ml), independientemente de la respuesta clínica. RESULTADOS: Se incluyeron 77 pacientes (23 colitis ulcerosa y 54 enfermedad de Crohn). Ambos grupos, PRO (n=41) y CLN (n=36) presentaron una eficacia inicial y a largo plazo sin diferencias significativas. En la semana 14 hubo un 61% de remisión clínica (RC) (58,5% PRO, 63,9% CLN) y un 80,5% de al menos respuesta parcial (RP) (80,5% PRO, 80,6% CLN). En la semana 54 hubo un 68,8% de RC (61% PRO, 77,8% CLN) y un 76,6% de al menos RP (73,2% PRO, 80,6% CLN). De los pacientes en RC en la semana 14 (24 PRO, 23 CLN), 13 del grupo PRO fueron intensificados por niveles infraterapéuticos. En este subgrupo no se observaron diferencias significativas en la pérdida de respuesta secundaria (PRO 0%, CLN 8,7%). CONCLUSIÓN: Un manejo proactivo no mejoró las tasas de respuesta ni la remisión en el primer año. La intensificación de pacientes en RC y niveles infraterapéuticos postinducción no parece prevenir de forma significativa la pérdida de respuesta secundaria en el primer año

INTRODUCTION: CT-P13 is a biosimilar drug of infliximab (IFX), effective in patients with inflammatory bowel disease (IBD). The monitoring of levels of IFX and anti-IFX antibodies is now considered part of the integral management. OBJECTIVE: To compare the clinical response according to a strictly clinical (CLN) or proactive (PRO) approach based on the monitoring of levels in week 14, in clinical practice. METHODS: We conducted a prospective study in IBD patients starting CT-P13. In the PRO group, levels of IFX and post-induction antibodies were systematically measured (week 14) and those with infraterapeutic levels (<3μg/ml) were intensified, irrespective of the clinical response. RESULTS: We included 77 patients (23 ulcerative colitis and 54 Crohn's disease). Both PRO (n=41) and CLN (n=36) groups showed initial and long-term efficacy without significant differences. At week 14, 61% clinical remission (CR) (58.5% PRO, 63.9% CLN) and 80.5% at least partial response (PR) (80.5% PRO, 80.6% CLN). In week 54, 68.8% CR (61% PRO, 77.8% CLN) and 76.6% at least PR (73.2% PRO, 80.6% CLN). Of the patients in CR in week 14 (24 PRO, 23 CLN), 13 of the PRO group were intensified due to infra-therapeutic levels. In this subgroup no significant differences were observed in secondary loss of response (PRO 0%, CLN 8.7%). CONCLUSION: Proactive management does not improve response or remission rates in the first year. The intensification of clinical remission patients with post-induction infratherapeutic levels does not seem to significantly prevent secondary loss of response in the first year

Clinical value of CT-P13 trough levels, an infliximab biosimilar, in the management of inflammatory bowel disease. / Utilidad clínica de la determinación de niveles de CT-P13, biosimilar de infliximab, en el control de la enfermedad inflamatoria intestinal.

INTRODUCTION: CT-P13 is a biosimilar drug of infliximab (IFX), effective in patients with inflammatory bowel disease (IBD). The monitoring of levels of IFX and anti-IFX antibodies is now considered part of the integral management. OBJECTIVE: To compare the clinical response according to a strictly clinical (CLN) or proactive (PRO) approach based on the monitoring of levels in week 14, in clinical practice. METHODS: We conducted a prospective study in IBD patients starting CT-P13. In the PRO group, levels of IFX and post-induction antibodies were systematically measured (week 14) and those with infraterapeutic levels (<3µg/ml) were intensified, irrespective of the clinical response. RESULTS: We included 77 patients (23 ulcerative colitis and 54 Crohn's disease). Both PRO (n=41) and CLN (n=36) groups showed initial and long-term efficacy without significant differences. At week 14, 61% clinical remission (CR) (58.5% PRO, 63.9% CLN) and 80.5% at least partial response (PR) (80.5% PRO, 80.6% CLN). In week 54, 68.8% CR (61% PRO, 77.8% CLN) and 76.6% at least PR (73.2% PRO, 80.6% CLN). Of the patients in CR in week 14 (24 PRO, 23 CLN), 13 of the PRO group were intensified due to infra-therapeutic levels. In this subgroup no significant differences were observed in secondary loss of response (PRO 0%, CLN 8.7%). CONCLUSION: Proactive management does not improve response or remission rates in the first year. The intensification of clinical remission patients with post-induction infratherapeutic levels does not seem to significantly prevent secondary loss of response in the first year.

Diverticulitis de Meckel perforada en un adulto como causa atípica de dolor abdominal / Perforated Meckel's diverticulitis in an adult as an atypical cause of abdominal pain

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Effectiveness of adalimumab for the treatment of ulcerative colitis in clinical practice: comparison between anti-tumour necrosis factor-naïve and non-naïve patients.

BACKGROUND: Ulcerative colitis (UC) treatment is focused to achieve mucosal healing, avoiding disease progression. The study aimed to evaluate the real-world effectiveness of adalimumab (ADA) in UC and to identify predictors of remission to ADA. METHODS: This cohort study used data from the ENEIDA registry. Clinical response, clinical remission, endoscopic remission, adverse events (AE), colectomy, and hospitalisations were evaluated; baseline characteristics and biological parameters were compared to determine predictors of response. RESULTS: We included 263 patients (87 naïve and 176 previously exposed to anti-tumour necrosis factor alpha, TNF). After 12 weeks, clinical response, clinical remission, and endoscopic remission rates were 51, 26, and 14 %, respectively. The naïve group demonstrated better response to treatment than the anti-TNF-exposed group at short-term. Clinical and endoscopic remission within 1 year of treatment was better in the naïve group (65 vs. 49 and 50 vs. 35 %, respectively). The rates of AE, dose-escalation, hospitalisations, and colectomy during the first year were higher in anti-TNF-exposed patients (40, 43, and 27 % vs. 26, 21, and 11 %, respectively). Patients with primary failure and intolerance to the first anti-TNF and severe disease were associated with worse clinical response. Primary non-response to prior anti-TNF treatment and severe disease were predictive of poorer clinical remission. Low levels of C-reactive protein (CRP) and faecal calprotectin (FC) at baseline were predictors of clinical remission. CONCLUSIONS: In clinical practice, ADA was effective in UC, especially in anti-TNF naïve patients. FC and CRP could be predictors of treatment effectiveness.

Estudio de enfermedad celíaca en pacientes adultos con diabetes mellitus de tipo 1 / Study of celiac disease in adults with type 1 diabetes mellitus

En el presente estudio determinamos los citados anticuerpos a 463 pacientes con DM1 y, a los que presentaban positividad para alguno de ellos, se les propuso la realización de una endoscopia con toma de biopsias de duodeno distal, y se clasificaron las lesiones histológicas, cuando existieron, según la clasificación de Marsh.Sesenta y dos de los 463 (13,4%) pacientes presentaron al menos uno de los 3 anticuerpos positivo y, de ellos, 42 accedieron a la realización de la endoscopia. En 14 pacientes (3% de los diabéticos) se encontraron alteraciones histológicas compatibles con EC. La mayoría de estos 14 pacientes no refería síntomas relacionados con la enfermedad, aunque varios presentaban alteraciones analíticas presentes frecuentemente en la EC. La existencia de datos clinicoanalíticos compatibles con EC fue independiente del grado de lesión histológica. Al analizar la sensibilidad y el valor predictivo positivo para cada anticuerpo, los ATG y EMA fueron los más sensibles, si bien la facilidad técnica de detección de los ATG mediante técnicas de ELISA hace, en nuestra opinión, que sea el de elección para la realización del cribado(AU)

Celiac disease (CD) presents a wide clinical spectrum. There are asymptomatic or oligosymptomatic forms, which are difficult to diagnose. Since patients with untreated CD can develop severe complications, early diagnosis of these forms is important. Consequently, in groups at risk for CD, such as patients with type 1 diabetes (DM1), screening through determination of antigliadin (AGA), anti-tissue transglutaminase (ATG) and antiendomysial antibodies (EMA) is recommended. In the present study, 463 DM1 patients were screened for these antibodies. Patients who were positive for one or more were offered an upper endoscopy to obtain distal duodenum biopsies. Histological lesions, when present, were classified using Marsh's classification. Of the 463 patients, 62 (13.4%) were positive for at least one of the three antibodies, and 42 accepted to undergo an endoscopy. Fourteen patients (3% of the DM1 patients) were histologically diagnosed with CD. Most of these patients had no symptoms of CD, although some showed laboratory findings frequent in CD. The presence of clinical or analytical data compatible with CD was independent of the grade of histological lesions. Finally, we calculated the sensitivity and positive predictive value for each antibody. The most sensitive were ATG and EMA. Because of the technical simplicity of determining ATG with ELISA, in our opinion, this test should be the option of choice for screening (AU)

[Study of celiac disease in adults with type 1 diabetes mellitus]. / Estudio de enfermedad celíaca en pacientes adultos con diabetes mellitus de tipo 1.

Celiac disease (CD) presents a wide clinical spectrum. There are asymptomatic or oligosymptomatic forms, which are difficult to diagnose. Since patients with untreated CD can develop severe complications, early diagnosis of these forms is important. Consequently, in groups at risk for CD, such as patients with type 1 diabetes (DM1), screening through determination of antigliadin (AGA), anti-tissue transglutaminase (ATG) and antiendomysial antibodies (EMA) is recommended. In the present study, 463 DM1 patients were screened for these antibodies. Patients who were positive for one or more were offered an upper endoscopy to obtain distal duodenum biopsies. Histological lesions, when present, were classified using Marsh's classification. Of the 463 patients, 62 (13.4%) were positive for at least one of the three antibodies, and 42 accepted to undergo an endoscopy. Fourteen patients (3% of the DM1 patients) were histologically diagnosed with CD. Most of these patients had no symptoms of CD, although some showed laboratory findings frequent in CD. The presence of clinical or analytical data compatible with CD was independent of the grade of histological lesions. Finally, we calculated the sensitivity and positive predictive value for each antibody. The most sensitive were ATG and EMA. Because of the technical simplicity of determining ATG with ELISA, in our opinion, this test should be the option of choice for screening.

Perfil antropométrico en seleccionados nacionales dewaterpolo / The anthropometric profile in elite waterpolo players

El objetivo de este estudio fue describir las características morfológicas de 3 categorías de selecciqnados nacionales de waterpolo en nuestro país. Se realiza un estudio transversal descriptivo de los parámetros morfológicos (peso, talla composición corporal y somatotipo) de 37 seleccionados nacionales de waterpolo pertenecientes a las categorías: infantil (N = 13), juvenil (N = 12) Y junior (N = 12). Los cuales se encontraban dentro de su programa de entrenamiento en fase de preparación general. Presentando las siguientes características para cada categoría: junior edad 18,6 +/- 1,1 años, peso 70,9 +/- 7,3kg, talla 178,8 +/- 8,2cm, % de masa grasa 8,5 +/- 3,7, % de masa muscular 49 +/- 2,5 y somatotipo 2,6-5,0-3,1 (d.s. +/- 1,0-1,3-1,5). Juvenil edad 17,4 +/- 0,7 años, peso 73,6 +/- 1O kg., talla 177,7 +/-62,cm, % grasa 1O,4 +/- 3,4, % masa muscular 48,2 +/- 2,6 y somatotipo 3,1-5,5-2,3 (d.s. +/- 1,0-0,7-0,7). Infantil edad 14,5 +/- 0,7años, peso 56,4 +/-5,1 kg., talla 167,8 +/- 5,4 cm, % grasa 13,5 +/- 1,9, %masa muscular 43,4 +/- 2,3 y somatotipo 2,7-4,9-3,0 (d.s. +/- 0,6-0,8-0,9). El comportamiento de estos parámetros es de acuerdo a la edad ascendente en cuanto a talla, pero no en peso ya que la categoría juvenil presenta un mayor peso corporal promedio contra la junior, debido probablemente a que la primera presenta un rango más amplio. Con lo que respecta a la composición corporal la masa grasa tiene un decremento conforme aumenta la edad, no así la masa muscular cuyo comportamiento es a la inversa por estar interrelacionadas. En relación al somatotipo la mesomorfia predomino en todas las categorías, y además en la juvenil el valor de la endomorfia es ligeramente mayor, debido a la amplitud morfológica de sus integrantes como se menciono anteriormente. Existen escasos reportes internacionales en cuanto a aspectos morfológicos de jugadores de waterpolo y nulos en nuestro país, sin embargo es un deporte olímpico con gran número de aficionados y practicantes a nivel mundial, por lo que creemos importante mencionar estas características de nuestros seleccionados. Con este estudio podemos concluir que nuestros jugadores elite no presentan grandes diferencias en cuanto a composición corporal y somatotipo con lo reportado por otros autores

The aim of this study was to analyze the morphological characteristics in three national teams ofwaterpolo players. This study was transversal and descriptive of the morphology characteristics in 37 elite players belonging to the three categories: infantile (N = 13), youth (N= 12) andjunior (N = 12). Reporting the next results for every group. Junior: age 18.6 +/- 1.1 years weight 70.9 +/-7.3 kg, height 178.8 +/- 8.2 cm, % body fat 8.5 +/- 3.7, % muscle mass 49 +/- 2.5 and somatotype 2.6-5.0-3.1 (sd. +/- 1.0-1.3-1.5). Youth: age 17.4 +/- 0.7 years, weight 73.6 +/- 1O.0 kg, height 177.7 +/- 6.2 cm, % body fat 1O.4 +/- 3.4, % muscle mas s 48.2 +/- 2.6 and somatotype 3.1-5.5-2.3 (sd. +/- 1.0-0.7-0.7). Infantile: age 14.5 +/-0.7 years, weight 56.4 +/- 5.1 kg, height 167.4 +/- 5.49 cm, % body fat 13.5 +/- 1.9 % muscle mas s 43.4 +/- 2.3 and somatotype 2.7-4.9-3.0 (sd. 0.6-0.8-0.9).These yardisticks are according to age in an upwards scale regarding size but not in average weight due to the fact that the youth has an average body weight against the junior. These national players show weight and size above the media of the population. Regarding the body composition the fat mas s decreases as coming of age, the opposite applies in muscular mass. In relation to the somatotype there are no major important differences. There are a few international reports regarding morphological aspects in waterpolo players and none in our country even though it is an olympic sport with a considerable number of followers and world wide players so it is important to mention the characteristics of our national players. With this study we can conclude that our elite players do not show great differences within body composition and somatotype with the data reported by others authors

Características antropométricas fisiológicas de jugadores de fútbol de la selección mexicana / Anthropometric and physiological characteristics in elite soccer players

El fútbol es el deporte más popular en el mundo, existen escasos reportes en nuestro país a cerca de las características morfológicas de los jugadores mexicanos. El objetivo del presente estudio fue describir las características morfofuncionales de la selección nacional que acudió al Mundial de Corea y Japón 2002. Se evaluaron a 20 jugadores (3 porteros y 17 jugadores de cancha) con edad promedio de 29+/-t3.01 años, talla 175+/-5.6 cm y peso 74+/-t5.62 kg. En cuanto a la composición corporal encontramos un porcentaje de grasa de 10+/-1.65, porcentaje de músculo 49+/-1.39 Y somatotipo 2.35-5.9-1.95. Con un franco predominio de la mesomorfia. La fuerza anaeróbica se evaluó con la prueba de salto vertical encontrando un promedio de 45+/-t9 cm. En la espirometría se obtuvo la Capacidad Vital Forzada de 5+/-0,811. El consumo máximo de oxígeno fue determinado por medios indirectos, en banda sin fin encontrando valores promedio de 64.4 ml/kg/min. Las características antropométricas y fisiológicas de los jugadores de fútbol deben ser tomadas en cuenta para determinar las condiciones por las cuales las habilidades puedan ser explotadas en beneficio del equipo así como independientemente de acuerdo a la posición que desempeñe el jugador

The soccer is the most popular sport in the word , but there are few reports in our country about morphological traits of Mexican players. The aim purpose of this study was todescribe the morphological characteristics of the Mexican team that attended the Korea-Japan Word Cup in 2002. Twenty players were samples including three goalkeepers and 17 fields players. Their age average was 29+/-3.01 years, height 175+/-5.6 cm, and weight 74+/-5.62 kg. Body composition: fat percentage 10+/-1.65%, 49+/- 1.39 % lean mass and somatotype 2.35-5.91.95. To evaluate the anaerobic power a highjump test was performed (45+/-9 cm). In spirometry, through the vital forced capacity 5+/-0,81 valve was obtained. The oxygen consumption was determined through indirect methods in treadmill and values found of 64.4 ml/kg/min. The anthropometric and physiological traits of soccer players must be token into consideration to determine the conditions through wich the abilities can be exploited for the benefit of the team regardless of the position ofthe player