Manuel J. Castillo Garzón

Oral Creatine Supplementation and Skeletal Muscle Metabolism in Physical Exercise

Creatine is the object of growing interest in the scientific literature. This is because of the widespread use of creatine by athletes, on the one hand, and to some promising results regarding its therapeutic potential in neuromuscular disease on the other. In fact, since the late 1900s, many studies have examined the effects of creatine supplementation on exercise performance. This article reviews the literature on creatine supplementation as an ergogenic aid, including some basic aspects relating to its metabolism, pharmacokinetics and side effects. The use of creatine supplements to increase muscle creatine content above ~20 mmol/kg dry muscle mass leads to improvements in high-intensity, intermittent high-intensity and even endurance exercise (mainly in nonweightbearing endurance activities). An effective supplementation scheme is a dosage of 20 g/day for 4–6 days, and 5 g/day thereafter. Based on recent pharmacokinetic data, new regimens of creatine supplementation could be used. Although there are opinion statements suggesting that creatine supplementation may be implicated in carcinogenesis, data to prove this effect are lacking, and indeed, several studies showing anticarcinogenic effects of creatine and its analogues have been published. There is a shortage of scientific evidence concerning the adverse effects following creatine supplementation in healthy individuals even with long-term dosage. Therefore, creatine may be considered as a widespread, effective and safe ergogenic aid.

Acceso telefónico para sordos al Sistema de Emergencias Sanitarias 061

La demanda de asistencia y el acceso inicial a los sistemas de atencion in situ para emergencias sanitarias se produce mediante la comunicacion telefonica a traves de un numero de marcacion rapida como es el 061. Este numero y el acceso al sistema de emergencias son comunes para el territorio nacional. En otros paises existen sistemas similares que usan el mismo o diferente numero (911, 112) de marcacion rapida. El acceso se realiza por via telefonica y mediante lenguaje oral. Como es obvio, la poblacion con deficit auditivo presenta una barrera infranqueable para acceder a tal sistema. El problema se plantea, sin solucion por el momento, en todos los paises de nuestro entorno 1 . Se han expresado protestas por la existencia de barreras de comunicacion para el acceso de la poblacion con deficiencia auditiva a los servicios de salud 1-3 . Un modo de comunicacion telematica muy extendido entre la poblacion sorda es el fax. Esta comunicacion se realiza mediante lenguaje escrito y con gran componente iconografico, por lo que resulta mas facilmente comprensible y asimilable 2 . Otras tecnologias mas recientes (short message systems de telefonia movil y correo electronico) no se encuentran todavia tan ampliamente extendidas y presentan complicaciones especificas de uso. De hecho, entre la poblacion con discapacidad auditiva espanola, el 70% posee fax, frente al 10% que cuenta con telefono movil de texto o un infimo porcentaje que tiene acceso a Internet. En este trabajo se ha desarrollado y validado un protocolo basado en la comunicacion grafica y el empleo del fax que permite a las personas con discapacidad auditiva el acceso al Sistema de Emergencias Sanitarias 061. El protocolo incluye un cuestionario grafico, donde el paciente indica al 061 el problema que presenta, y una respuesta que el 061 devuelve al paciente a modo de acuse de recibo. Esta respuesta puede incluir, tambien, unos consejos sanitarios que se pueden aplicar hasta que llega el recurso sanitario asignado.

Changing the Spanish-Mediterranean Diet

The incidence of coronary heart disease has been traditionally low in Mediterranean countries. This has been linked to the Mediterranean-style diet and its effect, among others, on the plasma-lipid profile. Nevertheless, there are important differences in dietary patterns among different regions in the Mediterranean area. In general, the Spanish-Mediterranean diet is characterized by a relatively high content of bread, fish, green vegetables, eggs, olive oil, and red wine; however, variations among different regions may result in differences in the plasma-lipid profile. We have detected significant differences in high-density lipoprotein (HDL) cholesterol levels among regions in close proximity. These differences can be attributed to varying dietary patterns. Compared with subjects on a standard Spanish-Mediterranean diet, subjects on a highmeat diet showed a worse plasma-lipid profile. This did not happen in subjects on a high-fish diet. Neither ovo-lactovegetarian or lactovegetarian subjects presented better risk ratios (low-density lipoprotein cholesterol /HDL-cholesterolor Apo B/Apo A) than control subjects. In fact, in healthy subjects the suppression of all animal products in their diet (except eggs and dairies) did not result in a more favorable lipid profile, whereas increasing full-fat dairy-product intake in ovo-lactovegetarian subjects resulted in a net deterioration. This deterioration could be reverted by increasing physical exercise.