Relação dos saltos vertical, horizontal e sêxtuplo com a agilidade e velocidade em crianças

The aim of the present study were: 1) To verify the relationship of vertical, horizontal and sextuple jumps with agility and velocity of 5, 10 and 25 m; 2) To verify the capacity of these jumps to predict the agility and 5, 10 and 25 m velocity performance in children. Twenty eight boys (9.47 ± 0.64 years) and thirty girls (9.69 ± 0.70 years) were evaluated. The correlation values between agility and velocity on 5, 10 and 25 m velocity were, respectively, r = 0.63, 0.51, 0.44 and 0.64 with vertical jump, r = 0.68, 0.62, 0.28 and 0.62 with sextuple jump, and r = 0.60, 0.50, 0.26 and 0.57 with horizontal jump. The vertical and sextuple jumps were able to predict the agility and 25 m velocity performance (p < 0.05). Furthermore, they demonstrated capacity to predict 5 and 10 m velocity, respectively (p < 0.05). The vertical and sextuple jump tests may be used for assessment and control of training with children practicing activities that require agility and velocity, since both jumps predicted the agility and velocity performance, which did not occur with the horizontal jump.Os objetivos do presente estudo foram: 1) verifi car a relação dos saltos vertical, horizontal e sêxtuplo com a agilidade e velocidade de 5, 10 e 25 m; 2) verifi car a capacidade desses saltos em predizer o desempenho da agilidade e velocidade de 5, 10 e 25 m em crianças. Vinte e oito meninos (9,47 ± 0,64 anos) e 30 meninas (9,69 ± 0,70 anos) foram avaliados. Os valores de correlação entre a agilidade, velocidade de 5, 10 e 25 m foram, respectivamente, r = 0,63, 0,51, 0,44 e 0,64 com o salto vertical, r = 0,68, 0,62, 0,28 e 0,62 com o salto sêxtuplo, e r = 0,60, 0,50, 0,26 e 0,57 com o salto horizontal. O salto vertical e o salto sêxtuplo foram capazes de predizer o desempenho da agilidade e da velocidade de 25 m (p < 0,05). Além disso, demonstraram capacidade de predizer a velocidade de 5 e 10 m, respectivamente (p < 0,05). Os testes de salto vertical e sêxtuplo podem ser utilizados para avaliação e controle do treinamento com crianças praticantes de atividades que demandam agilidade e velocidade, uma vez que ambos os saltos predisseram o desempenho da agilidade e velocidade, o que não ocorreu com o salto horizontal

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Spontaneous Breathing in Early Acute Respiratory Distress Syndrome: Insights From the Large Observational Study to UNderstand the Global Impact of Severe Acute Respiratory FailurE Study

OBJECTIVES: To describe the characteristics and outcomes of patients with acute respiratory distress syndrome with or without spontaneous breathing and to investigate whether the effects of spontaneous breathing on outcome depend on acute respiratory distress syndrome severity. DESIGN: Planned secondary analysis of a prospective, observational, multicentre cohort study. SETTING: International sample of 459 ICUs from 50 countries. PATIENTS: Patients with acute respiratory distress syndrome and at least 2 days of invasive mechanical ventilation and available data for the mode of mechanical ventilation and respiratory rate for the 2 first days. INTERVENTIONS: Analysis of patients with and without spontaneous breathing, defined by the mode of mechanical ventilation and by actual respiratory rate compared with set respiratory rate during the first 48 hours of mechanical ventilation. MEASUREMENTS AND MAIN RESULTS: Spontaneous breathing was present in 67% of patients with mild acute respiratory distress syndrome, 58% of patients with moderate acute respiratory distress syndrome, and 46% of patients with severe acute respiratory distress syndrome. Patients with spontaneous breathing were older and had lower acute respiratory distress syndrome severity, Sequential Organ Failure Assessment scores, ICU and hospital mortality, and were less likely to be diagnosed with acute respiratory distress syndrome by clinicians. In adjusted analysis, spontaneous breathing during the first 2 days was not associated with an effect on ICU or hospital mortality (33% vs 37%; odds ratio, 1.18 [0.92-1.51]; p = 0.19 and 37% vs 41%; odds ratio, 1.18 [0.93-1.50]; p = 0.196, respectively ). Spontaneous breathing was associated with increased ventilator-free days (13 [0-22] vs 8 [0-20]; p = 0.014) and shorter duration of ICU stay (11 [6-20] vs 12 [7-22]; p = 0.04). CONCLUSIONS: Spontaneous breathing is common in patients with acute respiratory distress syndrome during the first 48 hours of mechanical ventilation. Spontaneous breathing is not associated with worse outcomes and may hasten liberation from the ventilator and from ICU. Although these results support the use of spontaneous breathing in patients with acute respiratory distress syndrome independent of acute respiratory distress syndrome severity, the use of controlled ventilation indicates a bias toward use in patients with higher disease severity. In addition, because the lack of reliable data on inspiratory effort in our study, prospective studies incorporating the magnitude of inspiratory effort and adjusting for all potential severity confounders are required

Epidemiology and patterns of tracheostomy practice in patients with acute respiratory distress syndrome in ICUs across 50 countries

Background: To better understand the epidemiology and patterns of tracheostomy practice for patients with acute respiratory distress syndrome (ARDS), we investigated the current usage of tracheostomy in patients with ARDS recruited into the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG-SAFE) study. Methods: This is a secondary analysis of LUNG-SAFE, an international, multicenter, prospective cohort study of patients receiving invasive or noninvasive ventilation in 50 countries spanning 5 continents. The study was carried out over 4 weeks consecutively in the winter of 2014, and 459 ICUs participated. We evaluated the clinical characteristics, management and outcomes of patients that received tracheostomy, in the cohort of patients that developed ARDS on day 1-2 of acute hypoxemic respiratory failure, and in a subsequent propensity-matched cohort. Results: Of the 2377 patients with ARDS that fulfilled the inclusion criteria, 309 (13.0%) underwent tracheostomy during their ICU stay. Patients from high-income European countries (n = 198/1263) more frequently underwent tracheostomy compared to patients from non-European high-income countries (n = 63/649) or patients from middle-income countries (n = 48/465). Only 86/309 (27.8%) underwent tracheostomy on or before day 7, while the median timing of tracheostomy was 14 (Q1-Q3, 7-21) days after onset of ARDS. In the subsample matched by propensity score, ICU and hospital stay were longer in patients with tracheostomy. While patients with tracheostomy had the highest survival probability, there was no difference in 60-day or 90-day mortality in either the patient subgroup that survived for at least 5 days in ICU, or in the propensity-matched subsample. Conclusions: Most patients that receive tracheostomy do so after the first week of critical illness. Tracheostomy may prolong patient survival but does not reduce 60-day or 90-day mortality. Trial registration: ClinicalTrials.gov, NCT02010073. Registered on 12 December 2013

Identifying associations between diabetes and acute respiratory distress syndrome in patients with acute hypoxemic respiratory failure: an analysis of the LUNG SAFE database

Background: Diabetes mellitus is a common co-existing disease in the critically ill. Diabetes mellitus may reduce the risk of acute respiratory distress syndrome (ARDS), but data from previous studies are conflicting. The objective of this study was to evaluate associations between pre-existing diabetes mellitus and ARDS in critically ill patients with acute hypoxemic respiratory failure (AHRF). Methods: An ancillary analysis of a global, multi-centre prospective observational study (LUNG SAFE) was undertaken. LUNG SAFE evaluated all patients admitted to an intensive care unit (ICU) over a 4-week period, that required mechanical ventilation and met AHRF criteria. Patients who had their AHRF fully explained by cardiac failure were excluded. Important clinical characteristics were included in a stepwise selection approach (forward and backward selection combined with a significance level of 0.05) to identify a set of independent variables associated with having ARDS at any time, developing ARDS (defined as ARDS occurring after day 2 from meeting AHRF criteria) and with hospital mortality. Furthermore, propensity score analysis was undertaken to account for the differences in baseline characteristics between patients with and without diabetes mellitus, and the association between diabetes mellitus and outcomes of interest was assessed on matched samples. Results: Of the 4107 patients with AHRF included in this study, 3022 (73.6%) patients fulfilled ARDS criteria at admission or developed ARDS during their ICU stay. Diabetes mellitus was a pre-existing co-morbidity in 913 patients (22.2% of patients with AHRF). In multivariable analysis, there was no association between diabetes mellitus and having ARDS (OR 0.93 (0.78-1.11); p = 0.39), developing ARDS late (OR 0.79 (0.54-1.15); p = 0.22), or hospital mortality in patients with ARDS (1.15 (0.93-1.42); p = 0.19). In a matched sample of patients, there was no association between diabetes mellitus and outcomes of interest. Conclusions: In a large, global observational study of patients with AHRF, no association was found between diabetes mellitus and having ARDS, developing ARDS, or outcomes from ARDS. Trial registration: NCT02010073. Registered on 12 December 2013

Effects of an 8-week in-season upper limb elastic band training programme on the peak power, strength, and throwing velocity of junior handball players

Abstract Background Team handball is an intense sport with special requirements on technical and tactical skills as well as physical performance. The ability of handball players to make repeated powerful muscular contractions in pushing and throwing the ball is crucial to success. Objective This study investigated the effects of elastic band training on upper body peak power output, ball throwing velocity, and local muscle volume of junior handball players. Materials and Methods Thirty handball players (a single national-level Tunisian team) were randomly assigned to a control group (CG; n = 15) and an experimental group (EG; n = 15). Pre- and post-interventional measurements included force-velocity tests, one-repetition maximum (1RM) bench press and pull-over strength, ball throwing velocity in three types of throw (jumping shot, 3-step running throw, and standing throw), and anthropometric estimates of limb volumes. The EG additionally performed an elastic band training programme twice a week for 8 weeks immediately before engaging in regular handball training. The control group underwent no additional elastic band training. Results The EG demonstrated greater improvements in absolute and relative peak power (p &lt; 0.001; 49.3 ± 22.9 % and 47.9 ± 24.6 %, respectively), 1RM strength (p &lt; 0.001; 25.3 ± 2.2 % and 44.1 ± 9.0 % for 1RM bench press and pull over, respectively), and throwing velocity in all three types of ball throws (p &lt; 0.001; 25.1–26.1 %), compared to the CG (3.9–4.4 %). Limb volumes increased significantly (p = 0.001, 8.0 ± 7.5 %) in the EG, with no significant change (p = 0.175, 2.6 ± 7.0 %) in the CG. Conclusions We conclude that additional elastic band training performed twice a week for 8 weeks improves measures relevant to game performance, particularly strength, power, and ball throwing velocity

Predictors of Fielding Performance in Professional Baseball Players

The ultimate zone-rating extrapolation (UZR/150) rates fielding performance by runs saved or cost within a zone of responsibility in comparison with the league average (150 games) for a position. Spring-training anthropometric and performance measures have been previously related to hitting performance; however, their relationships with fielding performance measures are unknown. Purpose: To examine the relationship between anthropometric and performance measurements on fielding performance in professional baseball players. Methods: Body mass, lean body mass (LBM), grip strength, 10-yd sprint, proagility, and vertical-jump mean (VJMP) and peak power (VJPP) were collected during spring training over the course of 5 seasons (2007-2011) for professional corner infielders (CI; n = 17, fielding opportunities = 420.7 ± 307.1), middle infielders (MI; n = 14, fielding opportunities = 497.3 ± 259.1), and outfielders (OF; n = 16, fielding opportunities = 227.9 ± 70.9). The relationships between these data and regular-season (100-opportunity minimum) fielding statistics were examined using Pearson correlation coefficients, while stepwise regression identified the single best predictor of UZR/150. Results: Significant correlations (P \u3c. 05) were observed between UZR/150 and body mass (r = .364), LBM (r = .396), VJPP (r = .397), and VJMP (r = .405). Of these variables, stepwise regression indicated VJMP (R = .405, SEE = 14.441, P = .005) as the single best predictor for all players, although the addition of proagility performance strengthened (R = .496, SEE = 13.865, P = .002) predictive ability by 8.3%. The best predictor for UZR/150 was body mass for CI (R = .519, SEE = 15.364, P = .033) and MI (R = .672, SEE = 12.331, P = .009), while proagility time was the best predictor for OF (R = .514, SEE = 8.850, P = .042). Conclusions: Spring-training measurements of VJMP and proagility time may predict the defensive run value of a player over the course of a professional baseball season. © 2013 Human Kinetics, Inc

Disruption of the ATP8A2 gene in a patient with a t(10;13) de novo balanced translocation and a severe neurological phenotype

Mental retardation is a frequent condition that is clinically and genetically highly heterogeneous. One of the strategies used to identify new causative genes is to take advantage of balanced chromosomal rearrangements in affected patients. We characterized a de novo t(10;13) balanced translocation in a patient with severe mental retardation and major hypotonia. We found that the balanced translocation is molecularly balanced. The translocation breakpoint disrupts the coding sequence of a single gene, called ATP8A2. The ATP8A2 gene is not ubiquitously expressed, but it is highly expressed in the brain. In situ hybridization performed in mouse embryos at different stages of development with the mouse homologue confirms this observation. A total of 38 patients with a similar phenotype were screened for mutations in the ATP8A2 gene but no mutations were found. The balanced translocation identified in this patient disrupts a single candidate gene highly expressed in the brain. Although this chromosomal rearrangement could be the cause of the severe phenotype of the patient, we were not able to identify additional cases. Extensive screening in the mentally retarded population will be needed to determine if ATP8A2 haploinsufficiency or dysfunction causes a neurological phenotype in humans