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Acknowledgements The authors want to thank the young athletes for participating

Algunos de los primeros sntomas de una crisis metablica: demasiado sueo cambios en el comportamiento malhumor falta de hambre Otros sntomas que tambin pueden aparecer luego: fiebre nuseas diarrea vmitos hipoglucemia (niveles de azcar bajos en la sangre) Si no se trata la crisis metablica, el nio con CTD puede: tener dificultad para respirar tener un edema (inflamacin) en el cerebro tener convulsionesTambin se les conoce cmo ataques asimientos

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At last, in the mature stage, spermatozoa are released by ejaculation, where they gain motility so that they can go toward the oocyte and trigger fertilization [9]

Additionally, affected individuals may face rejection or discrimination from peers, romantic partners, and even family members due to their condition [9,14,19]

In addition, rebleeding is frequent, up to 60% within 1 year, without appropriate treatment to prevent it [15]