Effects training in hypoxia on cardiometabolic parameters in obese people: A systematic review of randomized controlled trial

The aim of the present review is to evaluate effects of intermittent hypoxia and exercise therapy in cardiometabolic parameters on adult obese people. Three well-known databases were selected: EMBASE, MEDLINE and Web of Science. Studies selection: Inclusion criteria were: (a) human healthy overweight or obese adults, (b) study randomized controlled trial, (c) original experimental study, (d) English languages and (e) therapy with intermittent hypoxia and exercise. The assessment of the methodological quality of each study was based upon the risk of bias (PEDro scale) and level of evidence (CBO Guidelines). five articles clearly met inclusion criteria and were reviewed to data extraction. In the hypoxia groups, weight, body mass index, waist circumference, waist-hip ratio, fat mass and lean mass improved in at least two studies in comparison with the baseline. Systolic blood pressure improved in one study. The lipid profile and the aerobic capacity were not reduced significantly. Results suggest that combined hypoxia with exercise may help to improve cardiometabolic parameters in obese people. [Abstract copyright: Copyright © 2018 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.

Offensive performance under numerical inequality during exclusions in female handball

Los objetivos de este estudio fueron: 1) describir las situaciones de desigualdad numérica como consecuencia de exclusiones durante el torneo de balonmano femenino en los Juegos Panamericanos 2015; 2) analizar la eficacia para relacionarla con el resultado final de los partidos. Todos los partidos jugados por los equipos clasificados del puesto 1 al 4 en el torneo fueron analizados, utilizando la metodología observacional. Se construyó un instrumento ad hoc para realizar la observación. Un total de 14 partidos fueron analizados, en los cuales ocurrieron 461 acciones de desigualdad numérica. Las diferencias estadísticas entre las categorías analizadas fueron comprobadas usando el test de chi-cuadrado. Diferencia estadísticamente significativa fue considerada cuando p < 0.05. La mayor cantidad de acciones se concentró durante la segunda parte de los partidos (p < 0.05). Los resultados mostraron a los ganadores siendo más eficaces que los perdedores en la mayoría de las variables estudiadas (p < 0.05). Los equipos ganadores convierten el mayor porcentaje del total goles convertidos y mostraron un porcentaje menor de lanzamientos fuera. Los ganadores mostraron un mejor rendimiento en su eficacia de ataque (números de goles en relación al número de ataques/posesiones) cuando juegan en inferioridad. Se concluyó que los equipos ganadores convierten más goles que los perdedores en estas situaciones y que son más eficaces durante las acciones de desigualdad numérica.UY-MoUC

RESPONSE OF INDICATORS MUSCLE AND KIDNEY DAMAGE TO A HALF-DISTANCE TRIATHLON IN NON-PROFESSIONAL TRIATHLETES

Triathlon is a sport modality that has been on the rise in recent years, and represents a great physical load for the body. Therefore, the first goal of the present study was to investigate physiological response in non-professional half-distance triathlon participants regarding to muscle and kidney damage. Secondly, we evaluated the short-term recovery of this competition. Blood parameters of muscle and kidney damage of seventeen trained and experienced male triathletes were assessed before (pre) and after (post) the competition and 24h (24h REC) and 48 h (48h REC) after the individual finish. After race there were significant increases in the concentrations of creatine kinase and Total Protein (≤0.005) compared with Pre- race. A significant decrease in the total bilirubin (Δ =-24.5%; p<0.05) and Total Protein (Δ =-11.4%; p<0.05) values compared with post-race were shown 24h after race finish. At 48h of recovery, Total Protein decrease significantly compared with post- (Δ =-10.8%; p<0.05) and shown lower values compared with Pre- race (Δ =-5.7%; p<0.05). Significant muscle damage is caused in non-professional triathletes as result of half-distance race competition and 48h of recovery could be not sufficient to the decrease of serum creatine kinase

Combination of Biomaterials and Extracellular Vesicles from Mesenchymal Stem-Cells: New Therapeutic Strategies for Skin-Wound Healing

Hard-to-heal chronic wounds associated with aging and high-prevalence pathologies, such as diabetes, are a global health problem. Therefore, it is necessary to advance effective treatments to accelerate wound healing. Among these potential treatments are new therapies based on mesenchymal stem cells (MSC) and their secretomes, including extracellular vesicles (EV). They have an important therapeutic potential for the treatment of chronic ulcers, due to their immunomodulatory activity, as well as their ability to induce angiogenesis, cell proliferation and cell migration. The use of MSC-derived EV in regenerative medicine involves cell-free therapies that decrease risks associated with cell therapies, such as the potential development of tumors. However, the short half-life of MSC-EV is a limitation for their clinical use. A therapeutic strategy to increase the regenerative efficiency of EV in wounds is to encapsulate them in biomaterials. The latter must protect and progressively release EV in damaged tissues, optimizing healing. Biomaterials that can be used include hydrogels. These, in addition to acting as a vehicle for sustained application of EV, can create favorable environments for wound healing. Thus, the aim of this review is to critically describe the latest advances in the development of such therapeutic strategies. It highlights the significance and clinical potential of these new therapies, as well as the need to develop clinical trials, to ascertain their performance

Clinical potential of mesenchymal stem cell-derived exosomes in bone regeneration

Bone metabolism is regulated by osteoblasts, osteoclasts, osteocytes, and stem cells. Pathologies such as osteoporosis, osteoarthritis, osteonecrosis, and traumatic fractures require effective treatments that favor bone formation and regeneration. Among these, cell therapy based on mesenchymal stem cells (MSC) has been proposed. MSC are osteoprogenitors, but their regenerative activity depends in part on their paracrine properties. These are mainly mediated by extracellular vesicle (EV) secretion. EV modulates regenerative processes such as inflammation, angiogenesis, cell proliferation, migration, and differentiation. Thus, MSC-EV are currently an important tool for the development of cell-free therapies in regenerative medicine. This review describes the current knowledge of the effects of MSC-EV in the different phases of bone regeneration. MSC-EV has been used by intravenous injection, directly or in combination with different types of biomaterials, in preclinical models of bone diseases. They have shown great clinical potential in regenerative medicine applied to bone. These findings should be confirmed through standardization of protocols, a better understanding of the mechanisms of action, and appropriate clinical trials. All that will allow the translation of such cell-free therapy to human clinic applications

Non-specific inhibition of dipeptidyl peptidases 8/9 by dipeptidyl peptidase 4 inhibitors negatively affects mesenchymal stem cell differentiation

DPP4 may play a relevant role in MSC differentiation into osteoblasts or adipocytes. Dipeptidyl peptidase 4 (DPP4) inhibitors (DPP4i), such as sitagliptin and vildagliptin, are used as antidiabetic drugs. However, vildagliptin is not a specific DPP4i and also inhibits DPP8/9, which is involved in energy metabolism and immune regulation. The aim of this study is to evaluate how sitagliptin, vildagliptin or 1G244 (a DPP8/9 specific inhibitor) may influence cell viability, as well as osteogenic and adipogenic differentiation in human mesenchymal stem cells (MSC). Viability, apoptosis, osteoblastogenesis and adipogenesis markers, as well as protein synthesis of β-catenin, were studied in MSC cultures induced to differentiate into osteoblasts or adipocytes in the presence or absence of sitagliptin, vildagliptin or 1G244. The two tested DPP4i did not affect MSC viability, but 1G244 significantly decreased it in MSC and osteoblast-induced cells. Additionally, 1G244 and vildagliptin inhibited osteogenesis and adipogenesis, unlike sitagliptin. Therefore, inhibition of DPP4 did not affect MSC viability and differentiation, whereas inhibition of DPP8/9 negatively affected MSC. To the best of our knowledge, these results show for the first time that DPP8/9 have an important role in the viability and differentiation of human MSC. This data can be considered for human clinical use of drugs affecting DPP8/9 activity

Bariatric surgery and calcifediol treatment, Gordian knot of severe-obesity-related comorbidities treatment

BackgroundObesity (OB) is a chronic metabolic disease with important associated comorbidities and mortality. Vitamin D supplementation is frequently administered after bariatric surgery (BS), so as to reduce OB-related complications, maybe including chronic inflammation.AimThis study aimed to explore relations between vitamin D metabolites and components of the inflammasome machinery in OB before and after BS and their relations with the improvement of metabolic comorbidities.Patients and methodsEpidemiological/clinical/anthropometric/biochemical evaluation was performed in patients with OB at baseline and 6 months after BS. Evaluation of i) vitamin-D metabolites in plasma and ii) components of the inflammasome machinery and inflammatory-associated factors [NOD-like-receptors (NLRs), inflammasome-activation-components, cytokines and inflammation/apoptosis-related components, and cell-cycle and DNA-damage regulators] in peripheral blood mononuclear cells (PBMCs) was performed at baseline and 6 months after BS. Clinical and molecular correlations/associations were analyzed.ResultsSignificant correlations between vitamin D metabolites and inflammasome-machinery components were observed at baseline, and these correlations were significantly reduced 6 months after BS in parallel to a decrease in inflammation markers, fat mass, and body weight. Treatment with calcifediol remarkably increased 25OHD levels, despite 24,25(OH)2D3 remained stable after BS. Several inflammasome-machinery components were associated with improvement in metabolic comorbidities, especially hypertension and dyslipidemia.ConclusionThe beneficial effects of vitamin D on OB-related comorbidities after BS patients are associated with significant changes in the molecular expression of key inflammasome-machinery components. The expression profile of these inflammasome components can be dynamically modulated in PBMCs after BS and vitamin D supplementation, suggesting that this profile could likely serve as a sensor and early predictor of the reversal of OB-related complications after BS

Influência da atividade física nos estados psicológicos de adultos durante a pandemia de covid-19

Introdução: Longos períodos de confinamento em casa podem levar ao medo, pânico, ansiedade e depressão, o que, por sua vez, pode estar relacionado à diminuição dos hábitos de atividade física. Objetivo: Determinar a associação entre as características da atividade física praticada e o risco de apresentar problemas de saúde mental em pessoas durante o confinamento. Métodos: Foi realizado um estudo multicêntrico, transversal e observacional em países ibero-americanos com uma amostra de 4.948 participantes, selecionados por meio de uma técnica de amostragem em bola de neve. O estudo teve início em 15 de março de 2020 e foi concluído em Agosto de 2020 por meio de um formulário online que incluiu perguntas sobre dados sociodemográficos e de saúde, além da avaliação do estado de saúde mental e características de atividade física. Resultados: As mulheres brasileiras com idade compreendida entre 18 e 29 anos que ficaram em casa mais de 19 horas por dia apresentaram um risco mais elevado para todos os problemas de saúde mental analisados neste estudo. Um baixo nível de atividade física durante o período de isolamento apresentou a maior probabilidade de risco de depressão em comparação com níveis mais elevados (OR = 1,317). Além disso, a utilização de um recurso não profissional para fazer atividade física foi um fator preditivo de estado de saúde mental adverso (OR Ansiedade = 1,396, OR Depressão = 1,452, e OR Estresse = 1,220). Conclusões: Um baixo nível de atividade física durante o período de isolamento está associado a maior prevalência de depressão, e a utilização de recursos profissionais para a atividade física pode ser um fator de proteção para os distúrbios de saúde mental.Introduction: Long periods of home confinement may lead to fear, panic, anxiety, and depression states, which, in turn, could drive to a reduction of active lifestyles. Objetive: To determine the association between the characteristics of the physical activity performed and the risk of experiencing mental health issues among peopleduring confinement. Methods: A multicenter, cross-sectional, and observational study design was conducted in Iberoamerican countries with a sample of 4,948 participants, selected through a snowball sampling technique. The study started on March 15th, 2020, and was completed in August 2020 through an online survey that includeddemographic and medical data, mental health status, and physical activity characteristics. Results: Brazilianwomen aged between 18 and 29 who stayed at home more than 19 hours per day presented a relevant higher risk for all the mental health problems analyzed in this study. A low level of physical activity during the isolation period presents the highest probability of depression compared to higher levels (OR = 1.317). In addition, using a no professional resource to do physical activity is a predictive factor of adverse mental health status (OR Anxiety= 1.396, OR Depression = 1.452, and OR Stress = 1.220). Conclusions: A low level of physical activity during a long isolation period is associated with a higher prevalence of depression, and the use of professional resources for physical activity may be a protective factor for mental health disorders

Efecto de un protocolo de entrenamiento interválico de alta intensidad sobre masa grasa corporal en adolescentes

ABSTRACT Background: Childhood and adolescence are key to the development of chronic disease stages, the distribution of fat an important factor in this regard. The aim of the study was to evaluate the effects on fat parameters of a high intensity program developed in adolescents during physical education classes. Methods: In 2013, 35 school-age children of Cáceres taken part in this study divided into two groups. The high-intensity group performed for 8 weeks, 4-6 sets of 20 seconds at maximal intensity with a ratio effort / recovery of 1: 3 to 1: 1. The other group, developed continuous aerobic exercise during the same time. It conducted an assessment of fat mass before and after the training program. Repeated measures ANOVA test was used to observe that there were no statistically significant differences. Results: Continuous aerobic training group showed statistically significant differences in intra-group analysis in the percentage of fat mass trunk (Pre: 15.66 ± 4.16 vs Post: 16.95 ± 4.03; +1, 29%; p = 0.04) and the percentage of total fat (Pre: 21.58 ± 3.93 / Post: 22.34 ± 3.70; p = 0.05). Statistically significant differences were not found in the analysis between-groups in any of the studied variables. Conclusions: The training program high intensity physical activity at school carried out during physical education classes did not improve fat mass parameters evaluated. However, maintaining these parameters could be a good result during the development of this stage, where an increase of these occurs.RESUMEN Fundamentos: La infancia y la adolescencia son etapas claves para el desarrollo de enfermedades crónicas, siendo la distribución de grasa un importante factor en este sentido. El objetivo del estudio fue evaluar los efectos sobre parámetros de grasa de un programa de alta intensidad desarrollado en adolescentes durante las clases de educación física. Métodos: Durante el año 2013, 35 escolares cacereños participaron en el estudio divididos en dos grupos. El grupo de alta intensidad realizó durante 8 semanas de 4 a 6 series de sprints de 20 segundos a máxima intensidad con una relación esfuerzo/recuperación de 1:3 a 1:1. El otro grupo desarrolló ejercicio aeróbico continuo durante el mismo tiempo. Se llevó a cabo una evaluación de la masa grasa antes y tras el programa de entrenamiento. El test ANOVA de medidas repetidas se usó para analizar si existían diferencias estadísticamente significativas entre ambos grupos. Resultados: El grupo de entrenamiento aeróbico continuo mostró diferencias estadísticamente significativas en el análisis intra-grupo en el porcentaje de masa grasa del tronco (Pre:15,66±4,16 vs Post:16,95±4,03; +1,29%; p=0,04) y el porcentaje de grasa total (Pre:21,58±3,93/Post:22,34±3,70; p=0,05). Conclusiones: El programa de entrenamiento de actividad física de alta intensidad en la escuela llevado a cabo durante las clases de Educación Física no mejoró los parámetros de masa grasa evaluados. Sin embargo, el mantenimiento de estos parámetros podría ser un buen resultado durante el desarrollo de esta etapa, donde se produce un incremento

Acute physiological response to a normobaric hypoxic exposure: sex differences

Although preliminary studies suggested sex-related differences in physiological responses to altitude/hypoxia, controlled studies from standardised exposures to normobaric hypoxia are largely lacking. Hence, the goals of this study were to provide information on cardiorespiratory responses to a 7-h normobaric hypoxia exposure and to explore potential differences between men and women. In this crossover study, a total of 15 men and 14 women were subjected to a 7-h exposure in normoxia (FiO2: 21%) and normobaric hypoxia (FiO2: 15%). Values of peripheral oxygen saturation, heart rate, systolic and diastolic blood pressure and respiratory gases were recorded every hour (8 time points), and oxygen saturation every 30 min (15 time points). Compared to normoxia, exposure to hypoxia significantly increased minute ventilation from baseline to hour 7 in males (+ 71%) and females (+ 40%), significantly greater in men (p < 0.05). A steeper decrease in peripheral oxygen saturation until 2.5 h in hypoxia was seen in females compared to males (p < 0.05). In conclusion, the ventilatory response to hypoxia was more pronounced in men compared to women. Moreover, during the first hours in hypoxia, peripheral oxygen saturation dropped more markedly in women than in men, likely due an initially lower and/or less efficient ventilatory response to moderate hypoxia. Those findings should be considered when performing interventions for therapy or prevention in normobaric hypoxia. Nevertheless, further large-scaled and well-controlled studies are needed