Can the curriculum be used to estimate critical velocity in young competitive swimmers?

The aims of the present study were to assess critical velocity using the swimmer curriculum in front crawl events and to compare critical velocity to the velocity corresponding to a 4 mmol·l(-1) of blood lactate concentration and to the velocity of a 30 min test. The sample included 24 high level male swimmers ranged between 14 and 16 years old. For each subject the critical velocity, the velocity corresponding to a 4 mmol·l(-1) of blood lactate concentration and the mean velocity of a 30 min test were determined. The critical velocity was also estimated by considering the best performance of a swimmer over several distances based on the swimmer curriculum. Critical velocity including 100, 200 and 400 m events was not different from the velocity of 4 mmol·l(-1) of blood lactate concentration. Critical velocity including all the swimmer events was not different from the velocity of a 30 min test. The assessment of critical velocity based upon the swimmer curriculum would therefore seem to be a good approach to determine the aerobic ability of a swimmer. The selection of the events to be included in critical velocity assessment must be a main concern in the evaluation of the swimmer. Key pointsCritical velocity using 100, 200 and 400 m events was not different from the velocity of 4 mmol·l(-1) of blood lactate concentration.Critical velocity using all the swimmer events was not different from the velocity of a 30 min test.The assessment of critical velocity based upon the swimmer curriculum seemed to be a good approach to determine the aerobic capacity of a swimmer.The decision on the events to be analysed must be a main concern in the evaluation of the swimmer critical velocity.info:eu-repo/semantics/publishedVersio

Intensive Blood Pressure Treatment Reduced Stroke Risk in Patients With Albuminuria in the SPRINT Trial

Background and Purpose- Albuminuria is associated with stroke risk among individuals with diabetes. However, the association of albuminuria with incident stroke among nondiabetic patients is less clear. Methods- We performed a post hoc analysis of the SPRINT (Systolic Blood Pressure Intervention Trial), which examined the effect of higher versus lower intensity blood pressure management on mortality in 8913 participants without diabetes. We fit unadjusted and adjusted Cox proportional hazards models to estimate the association of baseline albuminuria (urinary albumin-to-creatinine ratio ≥30 mg/g versus<30 mg/g) with stroke risk. We also assessed effect modification according to treatment arms. Results- Mean age was 68±9 years, 35% were female, and 30% were black. Median follow-up was 3.2 years, and 19% patients had baseline albuminuria. Incident stroke occurred in 129 individuals during follow-up. Albuminuria was associated with increased stroke risk (unadjusted hazard ratio, 2.24; 95% CI, 1.55-3.23; adjusted hazard ratio 1.73; 95% CI, 1.17-2.56). The association of albuminuria with incident stroke differed according to the randomized treatment arm (P interaction=0.03). In the intensive treatment arm, the association of albuminuria and stroke was nonsignificant (unadjusted hazard ratio, 1.25; 95% CI, 0.69-2.28), whereas, in the standard treatment arm, it was significant (unadjusted hazard ratio, 3.44; 95% CI, 2.11-5.61). Conclusions- In a post hoc analysis of SPRINT, baseline albuminuria (versus not) was associated with a higher risk of incident stroke, but this relationship appeared to be restricted to those in the standard treatment arm. Further studies are required to conclusively determine if reduction of albuminuria in itself is beneficial in reducing stroke risk. Clinical Trial Registration- URL: https://www.clinicaltrials.gov. Unique identifier: NCT01206062.info:eu-repo/semantics/publishedVersio

Does combined dry land strength and aerobic training inhibit performance of young competitive swimmers?

The aim of the current study was twofold: (i) to examine the effects of eight weeks of combined dry land strength and aerobic swimming training for increasing upper and lower body strength, power and swimming performance in young competitive swimmers and, (ii) to assess the effects of a detraining period (strength training cessation) on strength and swimming performance. The participants were divided into two groups: an experimental group (eight boys and four girls) and a control group (six boys and five girls). Apart from normal practice sessions (six training units per week of 1 h and 30 min per day), the experimental group underwent eight weeks (two sessions per week) of strength training. The principal strength exercises were the bench press, the leg extension, and two power exercises such as countermovement jump and medicine ball throwing. Immediately following this strength training program, all the swimmers undertook a 6 week detraining period, maintaining the normal swimming program, without any strength training. Swimming (25 m and 50 m performances, and hydrodynamic drag values), and strength (bench press and leg extension) and power (throwing medicine ball and countermovement jump) performances were tested in three moments: (i) before the experimental period, (ii) after eight weeks of combined strength and swimming training, and (iii) after the six weeks of detraining period. Both experimental and control groups were evaluated. A combined strength and aerobic swimming training allow dry land strength developments in young swimmers. The main data can not clearly state that strength training allowed an enhancement in swimming performance, although a tendency to improve sprint performance due to strength training was noticed. The detraining period showed that, although strength parameters remained stable, swimming performance still improved.info:eu-repo/semantics/publishedVersio

Meningite Crônica, Hidrocefalia E Paraplegia Medular Em Histoplasmose Não-sistêmica

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Remote spinal epidural hematoma after spinal anesthesia for caesarean section

In the last few decades there has been a widespread of the use of central neuraxial blockages (CNB) in obstetric patients. The complications from the CNB range from the bothersome to the crippling and life-threatening. Spinal epidural hematoma (SEH) is one of such severe complications. A 29-year-old pregnant woman at term, ASA II, was proposed for a caesarean section after inadequate progression of labour. Spinal anesthesia was administered and surgery was uneventful. The patient recovered from the motor and sensitive blockage but, twelve hours after the procedure, she started complaining of paresthesia over the lower limbs that progressed to paraplegia. An urgent magnetic resonance revealed a dorsally located SEH extending from D7 to D9, remote from the site of needle puncture. The patient was transferred and an emergency laminectomy and evacuation of the hematoma was conducted. One year after the event she remained with neurological deficits.info:eu-repo/semantics/publishedVersio

Atitudes, Conceções e Práticas dos Enfermeiros na Prestação de Cuidados às Famílias em Cuidados de Saúde Primários

Introdução: Assistir as famílias numa perspetiva sistémica, quer para promover a saúde, através do adoção de estilos de vida saudáveis, quer para promover o autocuidado no sentido de diminuir ou aliviar os sofrimentos emocionais, físicos e espirituais da doença, requer o aprofundamento e/ou aquisição de conhecimentos e habilidades de intervenção dirigidas à família. São muitos os fatores que contribuem para que os cuidados de enfermagem se mantenham centrados no indivíduo e não na família, desde as representações dos enfermeiros sobre família e enfermagem de família, a metodologia da organização dos cuidados de enfermagem, a escassez de recursos humanos e materiais até aos conteúdos e metodologias de formação. Metodologia: Os dados foram colhidos através de um questionário on-line constituído por 2 Escalas: “A Importância das Famílias nos Cuidados de Enfermagem – Atitudes dos Enfermeiros (IFCE-AE)”, e “Percepção dos Enfermeiros sobre a Enfermagem com Famílias (PEEF)”, numa amostra de 244 enfermeiros que exercem funções em Contexto comunitário na Administração Regional de Saúde do Norte. Resultados: Os valores médios obtidos na versão modificada da Escala “Importância da Família nos Cuidados de Enfermagem - Atitudes dos Enfermeiros (IFCE-AE)” foram superiores a 4 nas subescalas Família: parceiro dialogante e recurso de coping (4,17) e Família: recurso nos cuidados de enfermagem (4,32), e inferiores a 2 na subescala Família como um fardo (1,99). Na Escala “Percepção dos Enfermeiros sobre a Enfermagem com Famílias (PEEF)” obtivemos valores médios de 2,60 na subescala Perceção da Prática da Enfermagem com Famílias e 3,37 na subescala Importância Atribuída à Enfermagem com Famílias. Conclusão: Os valores obtidos em ambas as escalas evidenciam que os enfermeiros que exercem as suas funções em contexto comunitário possuem atitudes favoráveis à inclusão das famílias nos cuidados de enfermagem e atribuem elevada importância à enfermagem centrada famílias. Essas atitudes são potencializadas pela formação pós-graduada, quer a formação numa área especializada da enfermagem, quer a formação específica na área da enfermagem de família.info:eu-repo/semantics/publishedVersio

IRX-2, a Novel Immunotherapeutic, Enhances Functions of Human Dendritic Cells

Background: In a recent phase II clinical trial for HNSCC patients, IRX-2, a cell-derived biologic, promoted T-cell infiltration into the tumor and prolonged overall survival. Mechanisms responsible for these IRX-2-mediated effects are unknown. We hypothesized that IRX-2 enhanced tumor antigen-(TA)-specific immunity by up-regulating functions of dendritic cells (DC). Methodology/Principal Findings: Monocyte-derived DC obtained from 18 HNSCC patients and 12 healthy donors were matured using IRX-2 or a mix of TNF-α, IL-1β and IL-6 ("conv. mix"). Multicolor flow cytometry was used to study the DC phenotype and antigen processing machinery (APM) component expression. ELISPOT and cytotoxicity assays were used to evaluate tumor-reactive cytotoxic T lymphocytes (CTL). IL-12p70 and IL-10 production by DC was measured by Luminex® and DC migration toward CCL21 was tested in transwell migration assays. IRX-2-matured DC functions were compared with those of conv. mix-matured DC. IRX-2-matured DC expressed higher levels (p<0.05) of CD11c, CD40, CCR7 as well as LMP2, TAP1, TAP2 and tapasin than conv. mix-matured DC. IRX-2-matured DC migrated significantly better towards CCL21, produced more IL-12p70 and had a higher IL12p70/IL-10 ratio than conv. mix-matured DC (p<0.05 for all). IRX-2-matured DC carried a higher density of tumor antigen-derived peptides, and CTL primed with these DC mediated higher cytotoxicity against tumor targets (p<0.05) compared to the conv. mix-matured DC. Conclusion: Excellent ability of IRX-2 to induce ex vivo DC maturation in HNSCC patients explains, in part, its clinical benefits and emphasizes its utility in ex vivo maturation of DC generated for therapy. © 2013 Schilling et al