PLANTEAMIENTOS RELEVANTES SOBRE EL METABOLISMO DEL LACTATO Y SU RELACIÓN CON EL EJERCICIO FÍSICO.

El l objetivo de este texto es destacar colocar los puntos más importantes sobre la discusión actual sobre el metabolismo del lactato, basado en la revisión de literaturaespecializada, y dirigida a los siguientes puntos a: (i) producción, acumulación y remoción durante el esfuerzo físico, (ii) la imposibilidad bioquímica para la formación del ácido láctico (como tal) y de la acidosis láctica y los planteamiento alternativos acerca de la acidosis metabólica inducida por el ejercicio(estableciendo las posibles fuentes de protones de Hidrogenos[H+]) y, finalmente, (iii) el señalamiento de planteamientos que postulan al lactato como una molécula reporta beneficios en diversas direcciones: fuente gluconeogénica, y un efecto “alcalinizante” sobre el estado ácido-base

Traditional and Undulating Periodization on Body Composition, Strength Levels and Physical Fitness in Older Adults

Introduction: Undulating training has been investigated in sedentary and trained adults, but less is known about the influence of undulating training in older adults. Purpose: This study aimed to evaluate body composition, strength levels, and physical fitness in response to traditional or undulating training in older adults. Methods: A controlled, double-arm trial was conducted in eighteen older adults (10 males, 8 females; 64 ± 2.1 years; 165.12 ± 7.5 cm; 72.5 ± 11.4 kg; 26.5 ± 3.2 k·gm−2) who were randomly assigned to traditional (n = 9, TT) or undulating training (n = 9, UT) for eight weeks. Dual X-ray absorptiometry was used to measure fat-free mass (FFM), fat mass (FM), and bone mineral density (BMD). Strength levels were evaluated by the handgrip strength and the one-repetition maximum in vertical chest press, rowing machine, squat, monopodal horizontal leg press, and leg extension. In addition, functional capacity was assessed using the Senior Fitness Test (SFT). Statistical analysis included mean/median comparisons to establish the difference after the intervention (paired Student’s t-test or Wilcoxon test), and effect size calculations based on estimates. Results: After correction for fat-free adipose tissue, a significant increase in FFM was observed in both groups, while no significant changes were found in FM and BMD. Upper- and lower-limbs strength showed significant increases in both groups, although clinical significance varied among exercises. Favorable results were seen on the cardiorespiratory fitness and strength components of the SFT in both groups. Conclusions: The 8-week UT and TT protocols are valid options for improving FFM and increasing strength and functional capacity in women and men over 60 years of age.This study was supported by Laboratory Fivestars (Málaga) and the Universidad de Málaga (Campus de Excelencia Internacional Andalucía Tech). Partial funding for open access charge: Universidad de Málag

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Canagliflozin and Cardiovascular and Renal Outcomes in Type 2 Diabetes Mellitus and Chronic Kidney Disease in Primary and Secondary Cardiovascular Prevention Groups

Background: Canagliflozin reduces the risk of kidney failure in patients with type 2 diabetes mellitus and chronic kidney disease, but effects on specific cardiovascular outcomes are uncertain, as are effects in people without previous cardiovascular disease (primary prevention). Methods: In CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation), 4401 participants with type 2 diabetes mellitus and chronic kidney disease were randomly assigned to canagliflozin or placebo on a background of optimized standard of care. Results: Primary prevention participants (n=2181, 49.6%) were younger (61 versus 65 years), were more often female (37% versus 31%), and had shorter duration of diabetes mellitus (15 years versus 16 years) compared with secondary prevention participants (n=2220, 50.4%). Canagliflozin reduced the risk of major cardiovascular events overall (hazard ratio [HR], 0.80 [95% CI, 0.67-0.95]; P=0.01), with consistent reductions in both the primary (HR, 0.68 [95% CI, 0.49-0.94]) and secondary (HR, 0.85 [95% CI, 0.69-1.06]) prevention groups (P for interaction=0.25). Effects were also similar for the components of the composite including cardiovascular death (HR, 0.78 [95% CI, 0.61-1.00]), nonfatal myocardial infarction (HR, 0.81 [95% CI, 0.59-1.10]), and nonfatal stroke (HR, 0.80 [95% CI, 0.56-1.15]). The risk of the primary composite renal outcome and the composite of cardiovascular death or hospitalization for heart failure were also consistently reduced in both the primary and secondary prevention groups (P for interaction >0.5 for each outcome). Conclusions: Canagliflozin significantly reduced major cardiovascular events and kidney failure in patients with type 2 diabetes mellitus and chronic kidney disease, including in participants who did not have previous cardiovascular disease

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial

Background: Short-term treatment for people with type 2 diabetes using a low dose of the selective endothelin A receptor antagonist atrasentan reduces albuminuria without causing significant sodium retention. We report the long-term effects of treatment with atrasentan on major renal outcomes. Methods: We did this double-blind, randomised, placebo-controlled trial at 689 sites in 41 countries. We enrolled adults aged 18–85 years with type 2 diabetes, estimated glomerular filtration rate (eGFR)25–75 mL/min per 1·73 m 2 of body surface area, and a urine albumin-to-creatinine ratio (UACR)of 300–5000 mg/g who had received maximum labelled or tolerated renin–angiotensin system inhibition for at least 4 weeks. Participants were given atrasentan 0·75 mg orally daily during an enrichment period before random group assignment. Those with a UACR decrease of at least 30% with no substantial fluid retention during the enrichment period (responders)were included in the double-blind treatment period. Responders were randomly assigned to receive either atrasentan 0·75 mg orally daily or placebo. All patients and investigators were masked to treatment assignment. The primary endpoint was a composite of doubling of serum creatinine (sustained for ≥30 days)or end-stage kidney disease (eGFR <15 mL/min per 1·73 m 2 sustained for ≥90 days, chronic dialysis for ≥90 days, kidney transplantation, or death from kidney failure)in the intention-to-treat population of all responders. Safety was assessed in all patients who received at least one dose of their assigned study treatment. The study is registered with ClinicalTrials.gov, number NCT01858532. Findings: Between May 17, 2013, and July 13, 2017, 11 087 patients were screened; 5117 entered the enrichment period, and 4711 completed the enrichment period. Of these, 2648 patients were responders and were randomly assigned to the atrasentan group (n=1325)or placebo group (n=1323). Median follow-up was 2·2 years (IQR 1·4–2·9). 79 (6·0%)of 1325 patients in the atrasentan group and 105 (7·9%)of 1323 in the placebo group had a primary composite renal endpoint event (hazard ratio [HR]0·65 [95% CI 0·49–0·88]; p=0·0047). Fluid retention and anaemia adverse events, which have been previously attributed to endothelin receptor antagonists, were more frequent in the atrasentan group than in the placebo group. Hospital admission for heart failure occurred in 47 (3·5%)of 1325 patients in the atrasentan group and 34 (2·6%)of 1323 patients in the placebo group (HR 1·33 [95% CI 0·85–2·07]; p=0·208). 58 (4·4%)patients in the atrasentan group and 52 (3·9%)in the placebo group died (HR 1·09 [95% CI 0·75–1·59]; p=0·65). Interpretation: Atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease who were selected to optimise efficacy and safety. These data support a potential role for selective endothelin receptor antagonists in protecting renal function in patients with type 2 diabetes at high risk of developing end-stage kidney disease. Funding: AbbVie

Gestión del conocimiento. Perspectiva multidisciplinaria. Volumen 17

El libro “Gestión del Conocimiento. Perspectiva Multidisciplinaria”, Volumen 17 de la Colección Unión Global, es resultado de investigaciones. Los capítulos del libro, son resultados de investigaciones desarrolladas por sus autores. El libro es una publicación internacional, seriada, continua, arbitrada, de acceso abierto a todas las áreas del conocimiento, orientada a contribuir con procesos de gestión del conocimiento científico, tecnológico y humanístico. Con esta colección, se aspira contribuir con el cultivo, la comprensión, la recopilación y la apropiación social del conocimiento en cuanto a patrimonio intangible de la humanidad, con el propósito de hacer aportes con la transformación de las relaciones socioculturales que sustentan la construcción social de los saberes y su reconocimiento como bien público

Respuesta de parámetros hematológicos a una sesión de entrenamiento interválico de alta intensidad tipo crossfit®

Aim: To evaluate the hematologic response to a CrossFit®-based high-intensity interval training (HIIT) session. Method: Pre-experimental study involving nine men (25.4 ± 4.3 years). In this study, blood samples were taken before and after a HIIT training session of 15 minutes in the main phase. Hematological variables were analyzed through a blood count of fourth generation. Results: The obtained results showed a significant difference (p<0.05) in red blood cells (%Δ: -1.35; ES: 0,222), hemoglobin concentration (%Δ: -1,18; ES: 0,263), hematocrit percentage (%Δ: -1,72; ES: 0,448), Mean Corpuscular Volume (%Δ: -0,47; ES: 0,108), and lymphocyte (%Δ: -24,89; ES: 0,855), and eosinophils count (%Δ: -24,32; ES: 0,290) when comparing samples before and after the session. There were no significant changes in other parameters. Conclusion: It is necessary to go deeper in the study of hematological variables in the HIIT, in order to optimize performance parameters, decrease the prevalence of injuries, and improve nutrition and supplementation strategies.Objetivo: avaliar a resposta hematológica de uma sessão de treinamento intervalado de alta intensidade (TIAI) tipo CrossFit®. Método: estudo pre-experimental no qual se retirou mostras sanguíneas de 9 homens (25.4 ± 4.3 anos), antes e depois de uma sessão de CrossFIT®, com duração na fase principal de 15 minutos. As variáveis hematológicas foram analisadas por um quadro hemático de IV geração. Resultados: análise mostrou diferenças significativas (p<0.05) nos hematies (%Δ: -1.35; ES: 0,222), concentração de hemoglobina (%Δ: -1,18; ES: 0,263), percentagem de hematócrito (%Δ: -1,72; ES: 0,448), volume corpuscular médio (%Δ: -0,47; ES: 0,108), quantidade de linfócitos (%Δ: -1,72; ES: 0,448) e eosinófilos (%Δ: -24,32; ES: 0,290). Nos outros parâmetros do quadro hemático não houve diferenças significativas. Conclusão: de acordo com esses resultados, nota-se a necessidade de aprofundar os estudos hematológicos, para se aperfeiçoar parâmetros de rendimento, diminuição de riscos de lesões e melhorar a intervenção nutricional e de suplementação nesse tipo de treinamento.  El objetivo de este trabajo fue evaluar la respuesta hematológica a una sesión de entrenamiento interválico de alta intensidad (EIAI) tipo CrossFit®. Se realizó un estudio pre-experimental en donde participaron nueve hombres (25.4 ± 4.3 años), a los cuales se les realizó muestras sanguíneas antes y después de una sesión de EIAI, la cual tuvo una duración (fase principal) de 15 minutos. Las variables hematológicas fueron analizadas por un cuadro hemático de IV generación. El análisis de los resultados obtenidos mostró que se presentó una diferencia significativa (p<0.05) en los hematíes, concentración de hemoglobina, el hematocrito,  el recuento de linfocitos y los eosinófilos al comparar las muestras antes y después de la sesión. En conclusión, se hace necesario profundizar en el estudio de variables hematológicas en el EIAI, de manera que permita optimizar parámetros de rendimiento, disminuir la prevalencia de lesiones y mejorar las estrategias nutricionales y de suplementación.

Dermatoglyphic profile and physical condition of adolescent soccer players

El objetivo del estudio fue establecer la relación entre el perfil dermatoglífico y la condición física de los jugadores de fútbol de la selección sub-16 del Departamento de Córdoba, Colombia. Se evaluaron veinte jugadores, edad 15,20,3 años, talla 169,34,3 cm, masa corporal 58,75,0 kg, índice de masa corporal 20,52,1 kg/m2 y porcentaje de masa adiposa 10,22, 7 por ciento. Los niveles de fuerza explosiva de los miembros inferiores, de la potencia aeróbica, de la velocidad, agilidad y de la fuerza máxima de los miembros superiores, mostraron un buen desarrollo con relación a estudios nacionales e internacionales con poblaciones de la misma edad. El perfil dermatoglífico encontrado fue Arco 0,45 0,8; Presilla 6,5 2,7; Verticilo 3,0 3,0; SQTL 131,6 39.1 e Índice delta (D10) 12,6 3,5. Se encontró una correlación muy significativa (p=<0,00) entre el registro de los arcos y el salto largo sin impulso (SLSI). También se encontró correlación significativa (p=<0,05) entre la sumatoria de la cantidad total de líneas de las dos manos (SQTL) y el SLSI y entre D10 y el SLSI; pero, no se encontró correlación significativa entre las demás características dermatoglíficas y los indicadores de las capacidades físicasThe goal of the study was to establish the relationship between the dermatoglyph profile and the physical condition of the soccer players of the U16 team Cordoba State, Colombia. Twenty players were evaluated, age 15,2 0,3 years old, height 169,3 4,3 cm, body mass 58,7 5,0 kg, body mass index 20,5 2,1 kg/m2 and percentage of adipose mass 10,2 2,7 por ciento. The levels of explosive strength of the lower limbs, aerobic power, speed, agility and maximum strength of the upper limbs, showed a good development in relation to national and international studies with populations of the same age. The dermatoglyphic profile found was: Arch 0,45 0,8; Loop 6,5 2,7; Whorl 3,0 3,0; SQTL 131,6 39,1 and Delta index (D10) 12,6 3,5. A very significant correlation (p=<0,00) was found between arches and Standing Long Jump (SLJ). There was also a significant correlation (p=<0,05) between the sum of the quantity of total lines on both hands (SQTL) and SLJ, and between D10 and SLJ; but, no significant correlation was found between the other dermatoglyphic characteristics and the physical ability indicator

Perfil dermatoglífico y somatotipificación de jugadores adolescentes de fútbol (Dermatoglyphic profile and somatotyping of adolescent soccer players)

El propósito del presente estudio fue determinar el perfil dermatoglífico y la somatotipificación de un grupo de adolescentes (edad, 15.2 ± 0.3 años) de la selección de futbol del departamento de Córdoba, Colombia. Se realizaron mediciones antropométricas con las cuales se derivó indicadores como el índice de masa corporal (IMC), grasa corporal (GC) y el somatotipo; igualmente, se realizó registro de la huella dactilar y se determinó, siguiendo el protocolo de Cummins y Midlo (1942), los diseños digitales: Arco (A), Presilla (L) y Verticilo (W), Índice Delta (D10), sumatoria de la cantidad total de líneas (SQTL) y, adicionalmente, los tipos de fórmulas digitales (AL, ALW, 10L, 10W, LW y WL). Los resultados de los indicadores antropométricos fueron: IMC = 20.5 ± 2.1 kg∙m2, GC = 10.2 ± 2.7 %; los valores encontrados en los componentes del somatotipo fueron de 3.4 ± 0.5 – 4.6 ± 0.9 – 3.4 ± 1.1 (endomorfía – mesomorfía – ectomorfía, respectivamente). Con relación a los indicadores dermatoglíficos, se encontró una presencia de: A = 5%, L = 65% y W = 31%; el D10 = 12.6 ± 3.5 y la SQTL = 131.7 ± 39.1. Por otra parte, el predominio de fórmulas digitales fue de LW (40%), seguido de WL (20%) y ALW y 10L (con el 15% cada una) y menos frecuente la formula digital AL (10%). Con estos resultados se concluye que el IMC y la GC se encontró en los rangos aceptados para la edad y sexo; el somatotipo predominante en el grupo fue el mesomorfo balanceado