Correlación de las ratios de fuerza bilateral e ipsilateral con el equilibrio en atletas femeninas de taekwondo

[ES] Este estudio tuvo como objetivo analizarla fuerza isocinética de la rodilla de la pierna dominante (PL) y no dominante (NPL), las ratios de asimetría lateral y examinar su correlación con el equilibrio estático. Dieciséis mujeres atletas de taekwondo (TKD) participaron voluntariamente en el estudio. La fuerza de extensión (Ex) y flexión (Flx) isocinética de la rodilla se midieron en contracciones concéntricas/concéntricas (Con/Con) a velocidades angulares de 60°/s, 180°/s y 240°/s. Se calcularon las ratios ipsilaterales (H/Q) y bilaterales (H/H y Q/Q)isquiotibiales / cuádriceps. Los equilibrios estáticos se determinaron tomando el centro de presión corporal en los ejes X (COPX) e Y (COPY). El análisis estadístico se realizó mediante t-test de muestras pareadas y las tests de correlación de Pearson. Cuando se examinó la fuerza isocinética de la rodilla, se encontró que el parámetro de velocidad angular de 60°/s era significativamente diferente en la fase de Flx, mientras que las velocidades angulares de 180°/s y 240°/s eran significativamente diferentes en la fase de Ex a favor de las PLs. No hubo diferencias significativas en las ratios de fuerza bilateral e ipsilateral de todas las velocidades angulares. Hubo una correlación significativa entre HQ a 240°/s y COPX en términos de ratios de asimetría ipsilateral, y se encontró una correlación significativa entre HH a 60 °/s y COPX en términos de ratios de asimetría bilateral. Se encontró que había diferencias de fuerza entre las PL y NPL, pero no se observó asimetría. No se halló un alto nivel de correlación entre las ratios de asimetría lateral y el equilibrio en atletas femeninas de TKD.[EN] This study aimed to analyze preferred leg (PLs) and non-preferred leg (NPLs)isokineticknee strength, lateralasymmetry ratios and to examine their correlation with static balance. Sixteen female taekwondo (TKD) athletesvoluntarily participated in the study. Kneeisokinetic extension (Ex) and flexion (Flx) strength were measured in concentric / concentric (Con / Con) contractions at angular velocities of 60°/s, 180°/s, and 240°/s. Ipsilateral hamstring/ quadriceps (H/Q) and bilateral (H/H and Q /Q) ratios were calculated. Static balances were determined bytaking thecenter of body pressure in X (COPX) and Y (COPY) axis. Paired samplet-test and Pearson correlation tests were used in statistical analysis. When theisokineticknee strength was examined, it was found that 60°/s angular velocity parameterwas significantly different in Flx phase while 180°/s and 240°/s angular velocities were found to be significantlydifferent in Ex phase in favor of PLs. There was no significance in bilateral and ipsilateral strength ratios of all angularvelocities. There was a significant correlation between 240°/s HQ and COPX in terms of ipsilateral asymmetry ratioswhereas a significant correlation was found between 60°/s HH and COPX in terms of bilateral asymmetry ratios. It wasfound that therewere differences in strength between PL and NPLs, but no asymmetry was observed. There was no high level of correlation between lateral asymmetry ratios and balance in female TKD practitioners.[PT] Este estudo teve como objetivo analisar a força isocinética do joelho da perna preferida (PLs) e da perna não preferida (NPLs), as razões de assimetria lateral e examinar a sua correlação com o equilíbrio estático. Dezesseis mulheres atletas de taekwondo (TKD) participaram voluntariamente no estudo. A força de extensão (Ex) e flexão (Flx) isocinética do joelho foram medidas em contrações concêntricas / concêntricas (Con/Con) em velocidades angulares de 60°/s, 180°/s e 240°/s. Foram calculadas as rácios isquiotibiais / quadríceps ipsilaterais (H/Q) e bilaterais (H/H e Q/Q). Os equilíbrios estáticos foram determinados tomando o centro de pressão corporal nos eixos X (COPX) e Y (COPY). O teste t de amostra emparelhada e os testes de correlação de Pearson foram usados na análise estatística. Quando a força isocinética do joelho foi examinada, verificou-se que o parâmetro de velocidade angular de 60°/s foi significativamente diferente na fase Flx, enquanto as velocidades angulares de 180°/s e 240°/s foram significativamente diferentes na fase Ex em favor de PLs. Não houve significância nas rácios de força bilateral e ipsilateral de todas as velocidades angulares. Houve uma correlação significativa entre HQ de 240°/s e COPX, em termos de rácios de assimetria ipsilateral, enquanto uma correlação significativa foi encontrada entre HH de 60°/s e COPX em termos de rácios de assimetria bilateral. Verificou-se que havia diferenças de força entre PL e NPLs, mas nenhuma assimetria foi observada. Não houve um alto nível de correlação entre as rácios de assimetria lateral e equilíbrio em mulheres praticantes de TKD

Technical Aspects and Clinical Limitations of Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations

PURPOSE: Sperm DNA fragmentation (SDF) is a functional sperm abnormality that can impact reproductive potential, for which four assays have been described in the recently published sixth edition of the WHO laboratory manual for the examination and processing of human semen. The purpose of this study was to examine the global practices related to the use of SDF assays and investigate the barriers and limitations that clinicians face in incorporating these tests into their practice. MATERIALS AND METHODS: Clinicians managing male infertility were invited to complete an online survey on practices related to SDF diagnostic and treatment approaches. Their responses related to the technical aspects of SDF testing, current professional society guidelines, and the literature were used to generate expert recommendations via the Delphi method. Finally, challenges related to SDF that the clinicians encounter in their daily practice were captured. RESULTS: The survey was completed by 436 reproductive clinicians. Overall, terminal deoxynucleotidyl transferase deoxyuridine triphosphate Nick-End Labeling (TUNEL) is the most commonly used assay chosen by 28.6%, followed by the sperm chromatin structure assay (24.1%), and the sperm chromatin dispersion (19.1%). The choice of the assay was largely influenced by availability (70% of respondents). A threshold of 30% was the most selected cut-off value for elevated SDF by 33.7% of clinicians. Of respondents, 53.6% recommend SDF testing after 3 to 5 days of abstinence. Although 75.3% believe SDF testing can provide an explanation for many unknown causes of infertility, the main limiting factors selected by respondents are a lack of professional society guideline recommendations (62.7%) and an absence of globally accepted references for SDF interpretation (50.3%). CONCLUSIONS: This study represents the largest global survey on the technical aspects of SDF testing as well as the barriers encountered by clinicians. Unified global recommendations regarding clinician implementation and standard laboratory interpretation of SDF testing are crucial

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

Controversy and Consensus on Indications for Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations

Purpose: Sperm DNA fragmentation (SDF) testing was recently added to the sixth edition of the World Health Organization laboratory manual for the examination and processing of human semen. Many conditions and risk factors have been associated with elevated SDF; therefore, it is important to identify the population of infertile men who might benefit from this test. The purpose of this study was to investigate global practices related to indications for SDF testing, compare the relevant professional society guideline recommendations, and provide expert recommendations. Materials and Methods: Clinicians managing male infertility were invited to take part in a global online survey on SDF clinical practices. This was conducted following the CHERRIES checklist criteria. The responses were compared to professional society guideline recommendations related to SDF and the appropriate available evidence. Expert recommendations on indications for SDF testing were then formulated, and the Delphi method was used to reach consensus. Results: The survey was completed by 436 experts from 55 countries. Almost 75% of respondents test for SDF in all or some men with unexplained or idiopathic infertility, 39% order it routinely in the work-up of recurrent pregnancy loss (RPL), and 62.2% investigate SDF in smokers. While 47% of reproductive urologists test SDF to support the decision for varicocele repair surgery when conventional semen parameters are normal, significantly fewer general urologists (23%; p=0.008) do the same. Nearly 70% would assess SDF before assisted reproductive technologies (ART), either always or for certain conditions. Recurrent ART failure is a common indication for SDF testing. Very few society recommendations were found regarding SDF testing. Conclusions: This article presents the largest global survey on the indications for SDF testing in infertile men, and demonstrates diverse practices. Furthermore, it highlights the paucity of professional society guideline recommendations. Expert recommendations are proposed to help guide clinicians

Technical aspects and clinical limitations of sperm DNA fragmentation testing in male infertility: A global survey, current guidelines, and expert recommendations

Purpose Sperm DNA fragmentation (SDF) is a functional sperm abnormality that can impact reproductive potential, for which four assays have been described in the recently published sixth edition of the WHO laboratory manual for the examination and processing of human semen. The purpose of this study was to examine the global practices related to the use of SDF assays and investigate the barriers and limitations that clinicians face in incorporating these tests into their practice. Materials and Methods Clinicians managing male infertility were invited to complete an online survey on practices related to SDF diagnostic and treatment approaches. Their responses related to the technical aspects of SDF testing, current professional society guidelines, and the literature were used to generate expert recommendations via the Delphi method. Finally, challenges related to SDF that the clinicians encounter in their daily practice were captured. Results The survey was completed by 436 reproductive clinicians. Overall, terminal deoxynucleotidyl transferase deoxyuridine triphosphate Nick-End Labeling (TUNEL) is the most commonly used assay chosen by 28.6%, followed by the sperm chromatin structure assay (24.1%), and the sperm chromatin dispersion (19.1%). The choice of the assay was largely influenced by availability (70% of respondents). A threshold of 30% was the most selected cut-off value for elevated SDF by 33.7% of clinicians. Of respondents, 53.6% recommend SDF testing after 3 to 5 days of abstinence. Although 75.3% believe SDF testing can provide an explanation for many unknown causes of infertility, the main limiting factors selected by respondents are a lack of professional society guideline recommendations (62.7%) and an absence of globally accepted references for SDF interpretation (50.3%). Conclusions This study represents the largest global survey on the technical aspects of SDF testing as well as the barriers encountered by clinicians. Unified global recommendations regarding clinician implementation and standard laboratory interpretation of SDF testing are crucial

Controversy and consensus on the management of elevated sperm DNA fragmentation in male infertility: A global survey, current guidelines, and expert recommendations

Purpose Sperm DNA fragmentation (SDF) has been associated with male infertility and poor outcomes of assisted reproductive technology (ART). The purpose of this study was to investigate global practices related to the management of elevated SDF in infertile men, summarize the relevant professional society recommendations, and provide expert recommendations for managing this condition. Materials and Methods An online global survey on clinical practices related to SDF was disseminated to reproductive clinicians, according to the CHERRIES checklist criteria. Management protocols for various conditions associated with SDF were captured and compared to the relevant recommendations in professional society guidelines and the appropriate available evidence. Expert recommendations and consensus on the management of infertile men with elevated SDF were then formulated and adapted using the Delphi method. Results A total of 436 experts from 55 different countries submitted responses. As an initial approach, 79.1% of reproductive experts recommend lifestyle modifications for infertile men with elevated SDF, and 76.9% prescribe empiric antioxidants. Regarding antioxidant duration, 39.3% recommend 4–6 months and 38.1% recommend 3 months. For men with unexplained or idiopathic infertility, and couples experiencing recurrent miscarriages associated with elevated SDF, most respondents refer to ART 6 months after failure of conservative and empiric medical management. Infertile men with clinical varicocele, normal conventional semen parameters, and elevated SDF are offered varicocele repair immediately after diagnosis by 31.4%, and after failure of antioxidants and conservative measures by 40.9%. Sperm selection techniques and testicular sperm extraction are also management options for couples undergoing ART. For most questions, heterogenous practices were demonstrated. Conclusions This paper presents the results of a large global survey on the management of infertile men with elevated SDF and reveals a lack of consensus among clinicians. Furthermore, it demonstrates the scarcity of professional society guidelines in this regard and attempts to highlight the relevant evidence. Expert recommendations are proposed to help guide clinicians

Tensile behavior of post-installed chemical anchors embedded to low strength concrete

In the scope of this paper, tensile capacities of post-installed chemical anchors embedded to 5.9 and 10.9 MPa concrete blocks are investigated. Pull-out tests are applied to 80 ductile steel bars (S420a). For the anchor diameters, 12, 16 and 20 mm are chosen. On the other hand, 10, 15 and 20 times the bar diameter are selected as free-edge distance and embedment depth for monotonic tensile loading tests. The results indicate that installation of anchors into low-strength concrete with sufficient embedment depth and free-edge distance is not unsafe as previously expected. To obtain ductile failure in low strength concrete, free-edge distance and embedment depth of minimum 15 times the anchor diameter" should be required. Furthermore, a comparison of test results with AC! 318 capacities is done and it is observed that ACI 318 has quite an over-conservative approach for the tensile capacity of post-installed anchors when low-strength concrete is considered

Tensile behavior of post-installed chemical anchors embedded to low strength concrete

In the scope of this paper, tensile capacities of post-installed chemical anchors embedded to 5.9 and 10.9 MPa concrete blocks are investigated. Pull-out tests are applied to 80 ductile steel bars (S420a). For the anchor diameters, 12, 16 and 20 mm are chosen. On the other hand, 10, 15 and 20 times the bar diameter are selected as free-edge distance and embedment depth for monotonic tensile loading tests. The results indicate that installation of anchors into low-strength concrete with sufficient embedment depth and free-edge distance is not unsafe as previously expected. To obtain ductile failure in low strength concrete, free-edge distance and embedment depth of minimum 15 times the anchor diameter" should be required. Furthermore, a comparison of test results with AC! 318 capacities is done and it is observed that ACI 318 has quite an over-conservative approach for the tensile capacity of post-installed anchors when low-strength concrete is considered