Μεταβολές στους δείκτες της αερόβιας ικανότητας κατά την περίοδο διακοπής του πρωταθλήματος σε ερασιτέχνες αθλητές καλαθοσφαίρισης

Στη παρούσα πειραματική έρευνα θέλουμε να μελετήσουμε εάν κατά την περίοδο διακοπής του πρωταθλήματος παρουσιάζονται μεταβολές στην αερόβια ικανότητα των ερασιτεχνών αθλητών καλαθοσφαίρισης. Διακοπή του πρωταθλήματος έχουμε κατά την περίοδο εορτών και μετά το τέλος των αγωνιστικών υποχρεώσεων. Σε ερασιτεχνικό επίπεδο η διακοπή του πρωταθλήματος καλαθοσφαίρισης συνεπάγεται τη μείωση ή τη διακοπή προπόνησης. Στην έρευνα συμμετείχαν 15 ερασιτέχνες αθλητές καλαθοσφαίρισης, βασικοί και αναπληρωματικοί (n=15, ηλικίας 23.2±5.7 χρονών, ύψους 188.78±7.35 cm και βάρους 86.73±11.36 kg) οι οποίοι πραγματοποίησαν δύο δοκιμασίες μέγιστης κόπωσης, πριν τη διακοπή της προπόνησης (Τ1) και μετά από 14 ημέρες αποχής από οποιασδήποτε μορφής άσκησης (Τ2). Τα αποτελέσματα παρουσιάζουν ιδιαίτερο ενδιαφέρον. Η διακοπή της προπόνησης παρουσίασε μείωση στην αερόβια ικανότητα στο σύνολο των αθλητών. Βρέθηκε αύξηση του σωματικού βάρους κατά 1,77% και μείωση σε όλους τους άλλους δείκτες. Συγκεκριμένα, η VO2max είχε μείωση κατά 6,04%, η VO2 κατά 7,78%, ο Αναερόβιος ουδός μείωση 9,02%, το VE/VCO2 μείωση 3,24%, η VO2/t-slope μείωση 14,03% και ο Χρόνος Αναερόβιου ουδού μείωση 10,66%. Επίσης, κατά την ανάλυση των αποτελεσμάτων με βάση το ρόλο των παικτών, στους αναπληρωματικούς βρέθηκε στατιστικώς σημαντική αύξηση στο βάρος κατά 1,64% και μείωση στον Αναερόβιο ουδό 9,87%, στο VE/VCO2 12,14%, στον Χρόνο Αναερόβιου ουδού 17,59% και στον χρόνο άσκησης 12,06%. Αντίστοιχα στους βασικούς παίκτες βρέθηκε στατιστικώς σημαντική αύξηση στο σωματικό βάρος κατά 1,93% και μείωση στην VO2max(l/min) και στην VO2max(ml/kg/min) κατά 10,89% και 12,82% αντίστοιχα. Το διάστημα 14 ημερών επηρεάζει σε μεγάλο βαθμό την αερόβια ικανότητα των ερασιτεχνών αθλητών καλαθοσφαίρισης και συνεπώς την απόδοσή τους. Η μείωση της απόδοσης μπορεί να έχει επιπτώσεις σε ολόκληρη την ομάδα και στον προπονητή.In the research of this Master’s thesis we investigate changes in the aerobic capacity of amateur basketball players during a championship break. A break of the championship can take place during the holiday season and after the end of the championship. Usually, on an amateur level a break means reduction or total cessation of training. 15 amateur basketball players (n = 15, aged 23.2 ± 5.7 years, height 188.78 ± 7.35 cm and WEIGHT 86.73 ± 11.36 kg), starters and alternates, performed a maximum fatigue test twice, before the cessation of training (T1) and after 14 days of detraining (T2). The cessation of training resulted in a decrease of aerobic capacity to all athletes. O gain at WEIGHT of 1.77% and a decrease in all other indicators were found. Specifically, in VO2max(l/min) there was a decrease of 6.04%, in VO2max(lm/kg/min) 7.78%, in AT 9.02%, in VE / VCO2 3.24%, in VO2 / t-slope 14.03% and in AT TIME 10.66%. The analysis of the results based on the role of the players showed a statistically significant increase in WEIGHT of 1.64% and a decrease in AT 9.87%, in VE / VCO2 12.14%, in AT TIME 17,59% and in EXERCISE TIME 12.06% for the alternate group. A statistically significant increase in WEIGT of 1.93% and a decrease in VO2max(l/min) and VO2max(ml/kg/min) of 10.89% and 12.82% respectively was found for the starter group. The 14-day period of detraining affects the aerobic capacity of amateur basketball players and therefore their performance. A decreased performance during the championship can affect the whole team and the coach

Case Report Miller-Fisher Syndrome: Are Anti-GAD Antibodies Implicated in Its Pathophysiology?

Miller-Fisher syndrome (MFS) is considered as a variant of the Guillain-Barre syndrome (GBS) and its characteristic clinical features are ophthalmoplegia, ataxia, and areflexia. Typically, it is associated with anti-GQ1b antibodies; however, a significant percentage (>10%) of these patients are seronegative. Here, we report a 67-year-old female patient who presented with the typical clinical features of MFS. Workup revealed antibodies against glutamic acid decarboxylase (GAD) in relatively high titers while GQ1b antibodies were negative. Neurological improvement was observed after intravenous gamma globulin and follow-up examinations showed a continuous clinical amelioration with simultaneous decline of anti-GAD levels which finally returned to normal values. This case indicates that anti-GAD antibodies may be associated with a broader clinical spectrum and future studies in GQ1b-seronegative patients could determine ultimately their clinical and pathogenetic significance in this syndrome

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Prevalence of Cannabis Use Among Medical Students: A Systematic Review and Meta-analysis

Objective: Cannabis is reported to be the most common illicit substance used among medical students; however, the number of related studies is limited and their results are not systematically reviewed. The aim of our study was to analyze the prevalence of lifetime and current use of cannabis among medical students worldwide. Methods: A systematic review and meta-analysis was performed with adherence to the PRISMA guidelines. The electronic databases PubMed, Scopus, and Cochrane library were searched for studies on the prevalence of cannabis use among medical students. Prevalence of lifetime, past-year, and past-month cannabis use was extracted. Pooled prevalence and relative risk for sex were calculated using the random effects model and subgroup analyses were conducted. Results: A total of 38 observational (cross-sectional and cohort) studies were included (total number of participants 19 932), and most of them were conducted in Europe, Central and Southern America, and the United States. Overall pooled prevalence of lifetime cannabis use was 31.4% (95% confidence interval [CI]: 23.7%-39.6%), past-year use was 17.2% (95% CI: 10.8%-24.6%), and past-month use was 8.8% (95% CI: 5.6%-12.5%). Men displayed higher rates of cannabis use with a pooled relative risk of 1.55 (95% CI: 1.32-1.81). Heterogeneity was high ( I 2  > 75%) and there were differences among continents in all outcomes ( P  < .001). Conclusions: In conclusion, 1 in 3 medical students has used cannabis, whereas 8.8% were current users. Significant differences among continents were observed, but common finding was that male students tend to consume cannabis more often than female students

Multiple Sclerosis Patients Valuing Their Own Health Status: Valuation and Psychometric Properties of the 15D

An ongoing debate on decision and cost-utility analyses is whether to use preferences of general public or patients. The aim of this study was to replicate the valuation procedure of the multi-attribute utility generic measure, 15D, using a sample of multiple sclerosis (MS) patients and to assess its psychometric properties. Consecutive outpatient MS patients were recruited from two MS centers in Greece. The three-stage valuation procedure was applied and, with the use of elicited preference weights, an MS patients’ algorithm was developed. The original Finnish value set derived from healthy individuals was also used to calculate scores and a comparison between the two algorithms was made. A total of 64 MS patients were evaluated. The 15D scores obtained with the MS patients’ valuation algorithm were higher than the original one. The derived utilities differed significantly with respect to age, depressive symptoms, Expanded Disability Status Scale score and clinical form. MS patients indicated as most important domains mobility, mental functioning and vitality. Cronbach’s alpha was estimated 0.876 and correlations between relevant dimensions of the instruments were moderate to high. The 15D was generally feasible and reliable in patients with MS and the valuation system yielded acceptable psychometric properties

Miller-Fisher Syndrome: Are Anti-GAD Antibodies Implicated in Its Pathophysiology?

Miller-Fisher syndrome (MFS) is considered as a variant of the Guillain-Barre syndrome (GBS) and its characteristic clinical features are ophthalmoplegia, ataxia, and areflexia. Typically, it is associated with anti-GQ1b antibodies; however, a significant percentage (>10%) of these patients are seronegative. Here, we report a 67-year-old female patient who presented with the typical clinical features of MFS. Workup revealed antibodies against glutamic acid decarboxylase (GAD) in relatively high titers while GQ1b antibodies were negative. Neurological improvement was observed after intravenous gamma globulin and follow-up examinations showed a continuous clinical amelioration with simultaneous decline of anti-GAD levels which finally returned to normal values. This case indicates that anti-GAD antibodies may be associated with a broader clinical spectrum and future studies in GQ1b-seronegative patients could determine ultimately their clinical and pathogenetic significance in this syndrome