Reliability and criterion-related validity of a new repeated agility test.

The study aimed to assess the reliability and the criterion-related validity of a new repeated sprint T-test (RSTT) that includes intense multidirectional intermittent efforts. The RSTT consisted of 7 maximal repeated executions of the agility T-test with 25 s of passive recovery rest in between. Forty-five team sports players performed two RSTTs separated by 3 days to assess the reliability of best time (BT) and total time (TT) of the RSTT. The intra-class correlation coefficient analysis revealed a high relative reliability between test and retest for BT and TT (>0.90). The standard error of measurement (<0.50) showed that the RSTT has a good absolute reliability. The minimal detectable change values for BT and TT related to the RSTT were 0.09 s and 0.58 s, respectively. To check the criterion-related validity of the RSTT, players performed a repeated linear sprint (RLS) and a repeated sprint with changes of direction (RSCD). Significant correlations between the BT and TT of the RLS, RSCD and RSTT were observed (p<0.001). The RSTT is, therefore, a reliable and valid measure of the intermittent repeated sprint agility performance. As this ability is required in all team sports, it is suggested that team sports coaches, fitness coaches and sports scientists consider this test in their training follow-up.

Jumping performance profile of male and female gymnasts.

AIM: The aim of this study was to establish a more precise jumping performance profile of elite gymnasts than that published in previous studies. METHODS: Seventy-six elite male and female competitive gymnasts and 91 moderately active subjects volunteered for the study. The jumping tests performed on a contact mat were: squat jump (SJ) with progressive loads of 0%, 25%, 50 %, 75% and 100% of body mass, counter-movement jump (CMJ), and counter-movement jump with arm swing (CMJA). The parameters used to assess the jumping performance were flight time (FT, ms), FT normalized to body mass (FTbm, ms/kg), estimated elastic component (EC) and arm participation (AP). In SJ, the overload with respect to body mass had a negative impact on reliability in all of the subgroups that were analysed. When overloads were above 50% of body mass in SJ, reliability was poor. Therefore, overloads should not be used with sedentary young females. Gymnasts carry out a large number of jumps from very young ages, which may explain their high jump reliability (ICC>0.91). RESULTS: We used FT to estimate the F-v curve through SJ with overloads. The curves for male gymnasts and their controls were practically identical. However, when FT was normalized to body mass (FTbm), the F-v curve showed the advantage of female gymnasts in particular over their control group when overloads were above 50%. Larger, more significant (P<0.001) differences between gymnasts and their control groups were observed in CMJ and CMJA, with FTbm instead of FT. The combination of poor SJ and good CMJ performances explains why the EC was higher in gymnasts than in controls (+27%). CONCLUSION: The better AP of the gymnasts (+79%) may be due to better arm strength conditioning and segmental coordination. EC and AP can be considered a suitable complementary parameter of jumping performance in gymnasts.

Effect of glissade-step on kinetic and kinematic variables of stag ring leaps with and without throw-catch of the ball in rhythmic gymnastics.

This study focuses on certain characteristics of the jump take-offs in rhythmic gymnastics (RG). Rhythmic gymnasts always perform their jumps with the same preferred run-up technique, proceeded by a chassé-step in most of the cases. The overall idea was to analyse other step-techniques that could be performged on one-leg, which could prepare jumps. The aim of this study was to compare kinetic and kinematic variables between three-stag ring leaps with and without throwing-ball, performed using the glissade-step as a preparatory phase for take-off with one-leg these were as follows: glissade stag ring leap without-ball (GSWB), throw-ball glissade stag ring leap (TBGS) and glissade throw-ball stag ring leap (GTBS). Seven members of the Tunisian RG national team took part in this study. The technical elements were recorded in 2D using two-cameras on a specially designed floor carpet where a force-plate was integrated. The results showed that the three-leaps had significant impacts on the performance variables, especially on the force, the velocity and the flexibility. The GTBS was the most effective leap as the throw took place during the jump, which has increased its technicality and the applied physical variables, the vertical force, the rate of force development, the horizontal and vertical velocities and displacements.

[Pyogenic abscess of the psoas]. / Les abcès à pyogènes du psoas.

11 cases (7 primary and 4 secondary) of pyogenic psoas abscesses are reported. In all cases Staphylococcus aureus was isolated on blood culture or pus drained under ultra-sonographic control. US is very useful for diagnosis and the follow up of psoas pyogenic abscesses. Percutaneous aspiration and drainage of psoas abscesses under ultrasonographic control combined to antibiotherapy is an effective therapeutic procedure. Our experience suggests that antibiotherapy alone is an effective therapy of presuppurative pyogenic psoas abscesses and even in collected and non complicated primary psoas abscesses.

[Infection and rupture of a serous renal cyst]. / Infection et rupture du kyste séreux rénal.

The authors report two cases of acute infection of a renal cyst with rupture into the urinary tract. The diagnosis was made by excretory urograms and ultrasonography. Differentiating a ruptured cyst from congenital caliceal diverticulum may sometimes be difficult. Antimicrobial treatment can control the infection and exclusion of the cyst was obtained in one case. The mechanism responsible for infection and rupture of the cyst are discussed, as well as the management of such cases.

[Renal lithiasis and urothelial tumor]. / Lithiase rénale et tumeur de l'urothélium.

We report the cases of 4 patients with renal pelvis tumor associated with renal calculi. Sonography was correlated with gross pathology in three cases. The pre operative diagnostic can be made by sonography. The carcinogenic role of the lithiasis and infection is quite possible.

[Prostatic abscess. Apropos of 2 cases]. / L'abcès prostatique. A propos de deux cas.

Prostatic abscess in an acute inflammatory condition in which clinical diagnosis is not always easy. Ultrasound is of considerable help in diagnosis of this prostatic pathology. We report two cases. The first patient was treated by trans-rectal drainage. The second was treated with success by percutaneous drainage. The clinical, diagnostic and therapeutic aspects of this rare pathology are discussed.

[Abdominoscrotal hydrocele]. / L'hydrocèle abdominoscrotale.

The abdominoscrotal hydrocele (ASH) is a rare variant of hydrocele of the tunica vaginalis with fluid accumulation into the abdominal cavity passing through the inguinal canal. The etiology of ASH is not clear. The positive diagnosis depends on the clinical data (hydrocele + abdominal mass). It is confirmed by means of echography and or by TDM. The treatment is surgical complete resection of the vaginalis with ligation of the peritoneal cavity. This report concerns the observation of a huge ASH, so far described in a literature review. We try to distinguish the diagnostic and therapeutic elements of this exceptional pathology.

[Extra-adrenal pheochromocytoma. Report of two cases]. / Le Phéochromocytome extra-surrénalien. A propos de deux cas.

Paraganglioma is rare neoplasm. The authors report two new cases. The first case was a 36 year-old woman who presented with post-micturitional episodes of hypertension. Radiologic and endoscopic investigations showed a left submucosal bladder neck tumor. A partial cystectomy was performed under neuroleptanalgesia. The postoperative course was uneventful is simple. The second case was a 61 year-old woman who presented with a non secreting para-aortic paraganglioma.

[Calcified necrosing cystitis]. / La cystite nécrosante calcifiée.

Calcified necrotising cystitis is an urological curiosity, the authors report two cases. With subsidence of the acute process, regeneration and fibrosis take place, with contracture of the bladder and reduction of its capacity. Augmentation ileocystoplasty was performed with success in one case. The clinical and therapeutic aspects of this rare disease are discussed.

[Extra-renal retroperitoneal angiomyolipoma]. / Angiomyolipome rétropéritonéal extra-rénal.

Angiomyolipoma is a benign kidney tumour. Its extrarenal, retroperitoneal site is exceptional. The authors report a case and emphasise the value of ultrasonography and computed tomography in the diagnosis of these tumours with a marked fatty component, without neglecting the contribution of arteriography which can be useful in the diagnosis of the origin of very large retroperitoneal tumours.

[The treatment of ureteroceles complicated by calculi]. / Traitement des urétérocèles compliquées de lithiase.

In a series of 13 adults with calculi in ureteroceles, 10 cases underwent endoscopic meatotomy associated with endoscopic lithotripsy. In 2 bulky ureteroceles with calculi, the authors performed excision of the ureterocele and reimplantation of the ureter. In one case, the authors successfully performed extracorporeal lithotripsy. The authors obtained good results in all cases. Endoscopic meatotomy with lithotripsy is a very useful procedure for treatment of small or medium sized ureteroceles with calculi in adults.

[Renal transplantation from related live donors. Results and survival]. / Transplantation rénale à partir de donneurs vivants apparentés. Résultats et survie.

We report a retrospective study of 91 renal transplants from related live donors carried out at the Charles Nicolle Hospital, Tunis, between 1986 and 1993. There were 27 HLA-identical and 64 semi-identical. Classical immunosuppression based upon corticosteroids and azathioprine was used in the majority of cases. Surgical complications occurred in 15.4% of cases. 56% of patients had at least one acute rejection attack. There were 4 deaths, 3 related to infection and one to septic arterial rupture. Return to hemodialysis was related to chronic rejection in 5 cases and to recurrence of the initial nephropathy in one case. 5-year actuarial survival was 94% for recipients and 81% for grafts. In this series, acute rejection had no negative influence on graft survival and the difference between graft survival between HLA-identical and semi-identical patients was not statistically significant.

[Hemangioma of the renal calyx]. / Hémangiome caliciel du rein.

A case of renal hemangioma in a child is reported. The patient presented with severe painless hematuria. Intravenous pyelography showed a filling defect in the middle calyx of the right kidney. Ultrasonography showed a hypoechoic zone in the renal sinus. Hematuria was unilateral on right side at cystoscopy. Total nephrectomy was performed. The diagnosis was confirmed by histology.

[Ureteral stenoses and fistulas after kidney transplantation]. / Sténoses et fistules urétérales après transplantation rénale.

We report a retrospective study of 100 renal transplants, the majority using kidneys from related live donors. We saw 6 ureteric stenoses and four fistulas. Three relatively small stenoses and two limited fistulas were treated percutaneously, all of them successfully. The transplant had to be removed in two patients with a ureteric fistula. Four stenoses and one fistula were treated successfully by open surgery. Actuarial survival of grafts with a urological complication was significantly shorter than that of transplants free of such lesions.

[Role of in situ alkalinization in the treatment of obstructive uric acid lithiasis]. / Place de l'alcalinisation in situ dans le traitement de la lithiase urique obstructive.

The authors report a series of nine reno-ureteral obstructive uric acid calculi initially treated by percutaneous nephrostomy. After attempting stone dissolution by in situ alkalinization, they discuss the place of such a method among the various treatments for uric acid stones.

[Analytical study of 80 cases of lithiasic cholangitis]. / Etude analytique de 80 cas d'angiocholite lithiasique.

A retrospective study of 80 cases of lithiasic cholangitis treated between 1970 and 1982 demonstrated that cholangitis represents 45 p. 100 of the clinical manifestations of stones in the main biliary tract and 6.5 p. 100 of biliary surgery. This complication mainly affects female patients (3 out of 4 cases) and charcot's triad is the form that is most frequently encountered (81.25 p. 100 of cases). External drainage of the main biliary tract by Kerr's drain was performed in 32,5 p. 100 of cases and internal bypass operations in the remainder (A.B.D. : 36,15 p. 100, sphincterotomy : 32,25 p. 100). Mortality has reached 11,25 p. 100, including over half of the cases by cholangitis of uremic origin.

[Urachal cyst. Report of 3 cases]. / Le kyste de l'ouraque. A propos de trois observations.

The authors report three cases of cyst of the urachus, one of which was complicated by infection. This diagnosis is only rarely established clinically. The current performance of ultrasonography allows very precise analysis of the anterosuperior surface of the bladder, which may reveal the diagnosis. The authors discuss the problems raised by cysts of the urachus and emphasize the importance of clinical history, physical examination and complementary investigations, particularly CT which should allow the diagnosis of this disease, which needs to be treated surgically.

[Results of the treatment of renal lithiasis by percutaneous nephrolithotomy: apropos of 115 cases]. / Le résultat du traitement de la lithiase rénale par néphrolithotomie percutanée: à propos de 115 cas.

OBJECTIVES: The objective of this study was to analyse the results of percutaneous nephrolithotomy (PCNL), which was recently introduced into Tunisia, in order to determine its place among the treatment options for renal stones. MATERIAL AND METHODS: Our retrospective study was based on 115 consecutive PCNL procedures performed between April 1994 and November 1997. The stone was a single pelvic stone in 13 cases, lower caliceal in 15 cases, lower pyelocaliceal in 28 cases, partial staghorn in 20 cases, total staghorn in 16 cases and multiple pyelocaliceal in 23 cases. In our series, ultrasound lithotripsy constitutes the procedure of choice for renal stone fragmentation. RESULTS: A good result was obtained immediately in 67% of cases. This figure is lower than that published in the literature because of the complexity of the stones and the high failure rate due to the learning curve, involving 6 members of the team. In the case of failure, the procedure was converted to conventional surgery under the same anaesthetic in 20 patients. Residual stones, observed in 23 patients, were successfully treated by extracorporeal shock-wave lithotripsy (ESWL) in 79% of cases. By combining PCNL and ESWL, the good result rate was 80%. The mortality rate of this series was 0.8% and the morbidity rate was 7.5%. Complications were generally rare and often minor. CONCLUSION: PCNL occupies an important place in the treatment of renal stones. The results depend on the site, size and number of stones and on the operator's experience.

[Urinary fistula after transplantation: eleven cases]. / Fistule urinaire après transplantation: à propos de 11 cas.

OBJECTIVES: To specify the anatomical features of urinary fistulas and to evaluate the results of percutaneous and surgical treatment of post-transplantation urinary fistulas. PATIENTS AND METHODS: 11 urinary fistulas were observed after 160 renal transplantations, corresponding to an incidence of this complication of 6.8%. Urinary fistulas were treated percutaneously in three cases and surgically in eight cases. THE FOLLOWING COMPLICATIONS WERE OBSERVED DURING SURGICAL TREATMENT: extensive necrosis of the urethra in four cases, rupture of the sutures in two cases, a punctate pelvic fistula in one case. RESULTS: The incidence of fistula was 5.8% for Leadbetter reimplantation and 8.1% for Lich-Gregoir extravesical reimplantation. We obtained one success in three patients treated percutaneously and one death and seven successes out of eight patients treated surgically. We performed ureteropelvic anastomosis with the native ureter in the case of extensive necrosis of the ureter (4 cases), a new reimplantation in three cases and suture of the pelvic fistula in one case. CONCLUSION: More than one half of post-transplantation urinary fistulas observed in our department are secondary to ischaemic necrosis of the ureter. We emphasize the value of preservation of the ureteric blood supply during organ harvesting. Post-transplantation urinary fistulas must be treated surgically, as soon as possible, to avoid infectious complications.