Extended Match Time Exacerbates Fatigue and Impacts Physiological Responses in Male Soccer Players

Purpose This study evaluated how extended match time (90 + 30 min) affected physiological responses and fatigue in male soccer players. Methods Twenty competitive players (mean ± SD: Age, 20 ± 1 yr; maximal oxygen uptake, 59 ± 4 mL·min-1·kg-1) completed an experimental match with their activity pattern and heart rate assessed throughout the game, whereas countermovement jump performance and repeated sprint ability were tested and quadriceps muscle biopsies and venous blood samples were taken at baseline and after 90 and 120 min of match play. Results Less high-intensity running (12%) was performed in extra time in association with fewer intense accelerations and decelerations per minute compared with normal time. Peak sprint speed was 11% lower in extra time compared with normal time, and fatigue also manifested in impaired postmatch repeated sprint ability and countermovement jump performance (all P &lt; 0.05). Muscle glycogen declined from 373 ± 59 mmol·kg-1 dry weight (dw) at baseline to 266 ± 64 mmol·kg-1 dw after 90 min, with a further decline to 186 ± 56 mmol·kg-1 dw after extra time (P &lt; 0.05) and with single-fiber analyses revealing depleted or very low glycogen levels in 75% of both slow and fast twitch fibers. Blood glucose did not change during the first 90-min but declined (P &lt; 0.05) to 81 ± 8 mg·dL-1 after extra time. Plasma glycerol and ammonia peaked at 236 ± 33 mg·dL-1 and 75 ± 21 μmol·L-1 after the extra period. Conclusions These findings demonstrate exacerbated fatigue after extra time compared with normal time, which seems to be associated with muscle glycogen depletion, reductions in blood glucose levels, and hyperammonemia. Together, this points to metabolic disturbances being a major part of the integrated and multifaceted fatigue response during extended soccer match play.</p

The importance of chronic cardiopulmonary exercise in the development of oxidative stress in patients under chronic periodic hemodialysis

INTRODUCTION: Chronic Kidney Disease (CKD) affects 8-16% of the adult population. End Stage Renal Disease (ESRD) is related to 87% to hemodialysis (HD). ESRD patients under HD experience intense changes of redox status and systemic inflammation.AIM: This study aimed at investigating the efficacy of a 6-month intradialytic cardiopulmonary exercise training program on Redox Status (RS), inflammation, physical, functional performance and quality of life in patients with ESRD. MATERIAL AND METHOD: Twenty four HD patients were included in the study. Patients were assigned randomly to either an intradialytic Training (bedside cycling) Group (TG, N=12) or a Control Group (CG, N=12). TG was participating in the cardiopulmonary exercise program thrice/week during the HD session for 6 months while CG was just performing the HD session. Duration and intensity of the exercise was increasing gradually during the period of 6 months according to the tolerance of each patient. Anthropometrics [Body Mass (BM) and Height, Body Mass Index (BMI), body composition], physical performance (VO2peak), functional capacity [North Staffordshire Royal Infirmary (NSRI) walk test, Sit-to-Stand-60 (STS-60) test, quality of life (Short Form-36 /SF-36) as well as RS [thiobarbituric acid reactive substances (TBARS), protein carbonyls (PC), reduced (GSH) and oxidized (GSSG) glutathione, GSH/GSSG, total antioxidant capacity (TAC), catalase activity (CAT)] and high-sensitivity C-reactive protein (hs-CRP) were assessed at baseline and after the 6-month intervention. RESULTS: Twenty patients (10 in each group) completed the 6 month cardiopulmonary exercise training program. Peak oxygen consumption (VO2peak) increased by 15,3% only in TG (p<0.05). Performance in NSRI, STS-60 improved by 7,69% (p<0.05) and 12,56 (p<0.05) respectively only in TG, while quality of life (SF-36) appeared statistically important significance by 4% in TG. Exercise training reduced TBARS (by 42,95%) (p<0.05), PC (by 43,19%) (p<0.05) and hs-CRP (by 14,9%) (p<0.05) and elevated GSH (by 51,93%), (p<0.05), GSH/GSSG ratio (by 51,13%) (p<0.05), TAC (by 59,47%) (p<0.05) and CAT (by 15,07%) (p<0.05). CONCLUSION: These findings suggest that engagement in chronic intradialytic cardiovascular exercise alters RS, reduces inflammation and improves performance in patients with ESRD.ΕΙΣΑΓΩΓΗ: Η Χρόνια Νεφρική Νόσος (ΧΝΝ), υπολογίζεται ότι προσβάλλει το 8-16% του ενήλικου πληθυσμού. Η Τελικού Σταδίου Χρόνια Νεφρική Νόσος (ΤΣΧΝΝ), σχετίζεται σε ποσοστό 87% με την αιμοκάθαρση. Οι ασθενείς με ΤΣΧΝΝ υπό αιμοκάθαρση βιώνουν έντονες μεταβολές της οξειδοαναγωγικής κατάστασης και συστηματική φλεγμονή. ΣΚΟΠΟΣ: Σκοπός της παρούσας μελέτης είναι να διερευνήσει την αποτελεσματικότητα ενός προγράμματος καρδιοαναπνευστικής άσκησης διάρκειας 6 μηνών το οποίο εκτελείται κατά τη διάρκεια της αιμοκάθαρσης, ως προς τις μεταβολές της οξειδοαναγωγικής κατάστασης και της φλεγμονής, καθώς επίσης και ως προς την επίδραση στη φυσική, λειτουργική κατάσταση και στην ποιότητα ζωής των συγκεκριμένων ασθενών. ΥΛΙΚΟ ΚΑΙ ΜΕΘΟΔΟΣ: Είκοσι τέσσερις ασθενείς με ΤΣΧΝΝ υπό αιμοκάθαρση, συμπεριλήφθηκαν στη μελέτη. Οι συμμετέχοντες εντάχθηκαν τυχαιοποιημένα σε μία από τις δύο ομάδες: Α) Ομάδα Παρέμβασης (ΟΠ, Ν = 12) και Β) Ομάδα ελέγχου (ΟΕ, Ν = 12). Η ΟΠ συμμετείχε στο πρόγραμμα καρδιοαναπνευστικής προπόνησης, με συχνότητα 3 προπονήσεις ανά εβδομάδα, για 6 μήνες, κατά τη διάρκεια των συνεδριών αιμοκάθαρσης. Η ένταση και η διάρκεια των προπονήσεων αυξάνονταν προοδευτικά στο διάστημα της 6μηνης παρέμβασης, σύμφωνα με την ανοχή του κάθε ασθενή στην άσκηση. Η ΟΕ συμμετείχε μόνο στις συνεδρίες αιμοκάθαρσής Πριν και μετά την 6μηνη παρέμβαση όλοι οι συμμετέχοντες υποβλήθηκαν σε αξιολόγηση των ανθρωπομετρικών χαρακτηριστικών (ΣΒ, ύψος, ΔΜΣ, σύσταση σώματος), της φυσικής κατάστασης (VO2peak), της λειτουργικής ικανότητας (δοκιμασίες NSRI και STS-60) και της ποιότητας ζωής (SF-36). Επίσης υποβλήθηκαν σε αιμοληψία για την αξιολόγηση δεικτών οξειδωτικού στρες (TBARS,PC), φλεγμονής (hs-CRP) και της αντιοξειδωτικής ικανότητας (CAT, GSH, GSSG, λόγος GSH/GSSG, TAC). ΑΠΟΤΕΛΕΣΜΑΤΑ: Από το σύνολο των ασθενών οι 20 τελικά (10 από κάθε ομάδα) ολοκλήρωσαν την 6μηνη προπονητική παρέμβαση. Μετά από αυτήν παρατηρήθηκε αύξηση της VO2peak στην ΟΠ κατά 15,3% (p<0,05), βελτίωση της λειτουργικής ικανότητας επίσης στην ΟΠ μέσω των δοκιμασιών NSRI κατά 7,69%, (p<0,05) και STS-60 κατά 12,56%, (p<0,05), ενώ ως προς την ποιότητα ζωής (SF-36) παρατηρήθηκε στατιστικά σημαντικά αύξηση κατά 4% στην ΟΠ. Αναφορικά με τους δείκτες οξειδοαναγωγικής κατάστασης, η άσκηση επέφερε μείωση των TBARS κατά 42,95%, (p<0,05), των PC κατά 43,19%, (p<0,05) και του δείκτη φλεγμονής hs-CRP κατά 14,9%, (p<0,05), ενώ η GSH παρουσίασε αύξηση κατά 51,93%, (p<0,05), όπως επίσης και ο λόγος GSH/GSSG κατά 51,13%, (p<0,05), η TAC αυξήθηκε κατά 59,47%, (p<0,05) επίσης στην ίδια ομάδα ενώ τέλος και η CAT παρουσίασε αύξηση μετά την άσκηση κατά 15,07%, (p<0,05).ΣΥΜΠΕΡΑΣΜΑΤΑ : Σύμφωνα με τα παραπάνω ευρήματα, η χρόνια καρδιοαναπνευστική άσκηση κατά τη διάρκεια της αιμοκάθαρσης φαίνεται ότι επιδρά θετικά στην οξειδοαναγωγική κατάσταση των ασθενών, μειώνει τη φλεγμονή και βελτιώνει τη φυσική και λειτουργική κατάσταση των ασθενών με υπό αιμοκάθαρση ΤΣΧΝΝ

Abdominal Cocoon Syndrome: Two Cases of an Anatomical Abnormality

Introduction. Idiopathic sclerosing encapsulating peritonitis or abdominal cocoon syndrome (ACS) is a rare anatomical deformity characterized by the partial or complete encasement of the small intestine with fibrotic peritoneum. 193 cases have been described worldwide. The aim of this study is to present two cases of ACS successfully treated at the Surgical Clinic of the Agios Dimitrios General Hospital in Thessaloniki, Greece.Presentation of Cases. Two men (55 and 54 years old) presented to the emergency department complaining of abdominal pain, distension, constipation, nausea, and vomiting. Neither of these patients had any previous operations. The computed tomography scan of the first patient showed considerable distension of the small bowel, suggestive of internal herniation. The second case showed distention of the jejunum with no obvious cause. Both patients underwent emergency surgery. Intraoperatively, it was found that a fibrous membrane had completely covered the small intestine of the first patient and the jejunum and part of the large intestine of the second patient. Adhesiolysis and partial excision of the membrane were performed in both cases.Discussion. ACS is a rare cause of small bowel obstruction. Although conservative management with immunosuppressants and steroids has been described, surgical treatment is the gold standard.Conclusion. Preoperative clinical suspicion of this disease can help determine the diagnosis and protect surgeons from intraoperative “surprises”.</jats:p

Abdominal Cocoon Syndrome: Two Cases of an Anatomical Abnormality

Introduction. Idiopathic sclerosing encapsulating peritonitis or abdominal cocoon syndrome (ACS) is a rare anatomical deformity characterized by the partial or complete encasement of the small intestine with fibrotic peritoneum. 193 cases have been described worldwide. The aim of this study is to present two cases of ACS successfully treated at the Surgical Clinic of the Agios Dimitrios General Hospital in Thessaloniki, Greece. Presentation of Cases. Two men (55 and 54 years old) presented to the emergency department complaining of abdominal pain, distension, constipation, nausea, and vomiting. Neither of these patients had any previous operations. The computed tomography scan of the first patient showed considerable distension of the small bowel, suggestive of internal herniation. The second case showed distention of the jejunum with no obvious cause. Both patients underwent emergency surgery. Intraoperatively, it was found that a fibrous membrane had completely covered the small intestine of the first patient and the jejunum and part of the large intestine of the second patient. Adhesiolysis and partial excision of the membrane were performed in both cases. Discussion. ACS is a rare cause of small bowel obstruction. Although conservative management with immunosuppressants and steroids has been described, surgical treatment is the gold standard. Conclusion. Preoperative clinical suspicion of this disease can help determine the diagnosis and protect surgeons from intraoperative “surprises”

The Supraclavicular Artery Island Flap for Pharynx Reconstruction

The supraclavicular artery island flap (SCAIF) is a reliable, easy-to-harvest and versatile fasciocutaneous flap that can be used for pharynx reconstruction. Instead of free flaps, it requires no microsurgical technique, reduced operating time and postoperative care, making it an ideal option, especially during the COVID-19 pandemic. The primary aim of our study was to present two cases of a total laryngectomy and reconstruction with the SCAIF during the pandemic. The secondary aim was to review the literature concerning surgical techniques, complications and contradictions of the SCAIF for pharynx reconstruction. A literature search was performed using the PubMed, ScienceDirect, Wiley Online Library, Google Scholar, Scopus and Cochrane Library databases, using MeSH terms: larynx AND reconstruction AND flap. Ten full-text articles comprising 92 patients with 93 supraclavicular flaps were included. The patch graft, pharyngeal interposition graft, tubularization or &ldquo;U&rdquo;-shaped SCAIF were the main surgical techniques. Pharyngocutaneous fistula was the most frequent postoperative complication, especially in patients with previous radiotherapy, but just 19% of patients required secondary intervention. The lack of donor-site morbidity, low flap loss rates and stenosis rates favored this reconstructive option. This review underlined that the SCAIF has comparable results with other reconstructive options, consolidating this flap in the workhorse of pharynx reconstruction

The Supraclavicular Artery Island Flap for Pharynx Reconstruction

The supraclavicular artery island flap (SCAIF) is a reliable, easy-to-harvest and versatile fasciocutaneous flap that can be used for pharynx reconstruction. Instead of free flaps, it requires no microsurgical technique, reduced operating time and postoperative care, making it an ideal option, especially during the COVID-19 pandemic. The primary aim of our study was to present two cases of a total laryngectomy and reconstruction with the SCAIF during the pandemic. The secondary aim was to review the literature concerning surgical techniques, complications and contradictions of the SCAIF for pharynx reconstruction. A literature search was performed using the PubMed, ScienceDirect, Wiley Online Library, Google Scholar, Scopus and Cochrane Library databases, using MeSH terms: larynx AND reconstruction AND flap. Ten full-text articles comprising 92 patients with 93 supraclavicular flaps were included. The patch graft, pharyngeal interposition graft, tubularization or “U”-shaped SCAIF were the main surgical techniques. Pharyngocutaneous fistula was the most frequent postoperative complication, especially in patients with previous radiotherapy, but just 19% of patients required secondary intervention. The lack of donor-site morbidity, low flap loss rates and stenosis rates favored this reconstructive option. This review underlined that the SCAIF has comparable results with other reconstructive options, consolidating this flap in the workhorse of pharynx reconstruction

Eugenol Reduced &Mu;PO, CD45 and HMGB1 Expression and Attenuated the Expression of Leukocyte Infiltration Markers in the Intestinal Tissue in Biliopancreatic Duct Ligation-Induced Pancreatitis in Rats

Background and Objectives: Inflammation and dysregulation in the intestinal barrier function in acute pancreatitis (AP) trigger pancreatic lesions, systemic inflammatory response, and multiple organ dysfunction. Eugenol, as the main component of clove (Syzygium aromaticum), is known for its antioxidant and anti-inflammatory properties. We studied the potentially beneficial effect of eugenol in a rodent model of biliopancreatic duct ligation-induced AP. Materials and Methods: Rats were randomly divided into three groups: Sham, AP, and AP + eugenol (15 mg/kg/day). Serum TNF&alpha;, IL-6, IL-18, and resistin levels, as well as IL-6, TNF&alpha;, MPO, HMGB1, and CD45 tissue expression, were determined at various timepoints after the induction of AP. Results: Eugenol attenuated hyperemia and inflammatory cell infiltration in the intestinal mucosal, submucosal, and muscular layers. IL-6 and resistin serum levels were significantly reduced in the AP + eugenol group, while serum TNF&alpha; and IL-18 levels remained unaffected overall. TNF&alpha; pancreatic and intestinal expression was attenuated by eugenol at 72 h, while IL-6 expression was affected only in the pancreas. MPO, CD45, and HMGB1 intestinal expression was significantly reduced in eugenol-treated rats. Conclusions: Eugenol managed to attenuate the inflammatory response in the intestine in duct ligation-induced AP in rats

The Supraclavicular Artery Island Flap for Pharynx Reconstruction

The supraclavicular artery island flap (SCAIF) is a reliable, easy-to-harvest and versatile fasciocutaneous flap that can be used for pharynx reconstruction. Instead of free flaps, it requires no microsurgical technique, reduced operating time and postoperative care, making it an ideal option, especially during the COVID-19 pandemic. The primary aim of our study was to present two cases of a total laryngectomy and reconstruction with the SCAIF during the pandemic. The secondary aim was to review the literature concerning surgical techniques, complications and contradictions of the SCAIF for pharynx reconstruction. A literature search was performed using the PubMed, ScienceDirect, Wiley Online Library, Google Scholar, Scopus and Cochrane Library databases, using MeSH terms: larynx AND reconstruction AND flap. Ten full-text articles comprising 92 patients with 93 supraclavicular flaps were included. The patch graft, pharyngeal interposition graft, tubularization or “U”-shaped SCAIF were the main surgical techniques. Pharyngocutaneous fistula was the most frequent postoperative complication, especially in patients with previous radiotherapy, but just 19% of patients required secondary intervention. The lack of donor-site morbidity, low flap loss rates and stenosis rates favored this reconstructive option. This review underlined that the SCAIF has comparable results with other reconstructive options, consolidating this flap in the workhorse of pharynx reconstruction.</jats:p

It Is Written in the Clot: Coagulation Assessment in Severe Burn Injury

Background: Coagulopathy in severe burn injury is associated with complications and mortality. Methods: We compared 3 tests (EXTEM, INTEM, FIBTEM) of rotational thromboelastometry (ROTEM), a viscoelastic coagulation assay (VCA), with conventional coagulation assays (CCAs), fibrinogen, d-dimers and coagulation factors during the five post-burn days in survivors and non-survivors with severe burn injury, in order to correlate the results with burn coagulopathy and prognosis. Results: Seventeen survivors and ten non-survivors, with mean total burn surface area of 33.78% were included. CCAs measurements were abnormal, but unable to detect coagulopathy. At day 2, D-dimers and fibrinogen levels were statistically augmented for non-survivors. Regarding VCAs, FIBTEM MCF increased for non-survivors at day 2 and remained increased for the whole post-burn period. Furthermore, FIBTEM A10 and A20 at day 2 and EXTEM A10, EXTEM A20, EXTEM MCF, and EXTEM CFT at day 5 took abnormal values for the same group (p &lt; 0.05). These changes were underlined through abnormal measurements of coagulation factors. Conclusions:CCAs are poor indicators of coagulation status in burn injury, whereas VCAs are more sensitive markers, demonstrating coagulopathy and patients at greater risk of mortality