Physical fitness evaluation of paralympic winter sports sitting athletes.

OBJECTIVE: To provide normative values of physical fitness in Paralympic winter sports athletes competing in a sitting posture and to identify the components relevant for successful performance. DESIGN: Cross-sectional study with sports. SETTING: The Institute of Sports Medicine and Science of the Italian National Olympic Committee (Rome, Italy). PARTICIPANTS: Fifteen Alpine skiers (3 BP), 16 Nordic skiers (2 BP), 10 curlers (2 BP), and 34 ISH players (7 BP). INDEPENDENT VARIABLES: Curling, Alpine skiing, Nordic skiing, and ice sledge hockey (ISH). MAIN OUTCOME MEASURES: Physical fitness components. Oxygen uptake peak (V[Combining Dot Above]O2peak; L·min and mL·kg·min), mechanical work in a high-intensity exhaustion exercise (MW-HIE; kJ and kJ·kg), upper-body strength (N and N·kg), mean explosive power (MEP; W and W·kg) in a 10-second arm cranking ergometer Wingate test, and fat mass (FM) (% body mass) were primary outcome measures when assessed in the whole sport groups and secondary outcome measures when separating the BP from the others. RESULTS: Based on 1-way analysis of variance and Tukey post hoc test (P < 0.05), V[Combining Dot Above]O2peak and MW-HIE were highest in Nordic skiers (2.9 ± 0.53 L·min and 18.3 ± 3.98 kJ) and similar in ISH players and Alpine skiers (2.5 ± 0.42 and 2.3 ± 0.44 L·min and 17.4 ± 2.62 and 16.8 ± 7.41 kJ, respectively). Alpine skiers showed the highest absolute strength values (1210.1 ± 220.92 N). Curlers had the highest FM (26.2% ± 7.74%) and the lowest V[Combining Dot Above]O2peak (1.8 ± 0.35 L·min), MW-HIE (11.4 ± 2.40 kJ), and MEP (251.1 ± 67.16 W). Among the BP, Nordic skiers, ISH players, and Alpine skiers showed VO2peak, MW-HIE, and strength equal to 3.4 ± 0.60, 2.9 ± 0.38, and 2.8 ± 0.18 L·min⁻¹ and 22.6 ± 4.04, 19.4 ± 2.84, and 18.4 ± 7.86 kJ, and 975.4 ± 115.03, 1183.4 ± 60.43, and 1279.2 ± 279.1 N, [corrected] respectively. CONCLUSIONS: Analyzing physical fitness data of athletes competing in the last 4 winter Paralympic Games, normative values are provided. The specific components that are highly developed in the BP are considered relevant for successful performance.

Umbilical metastases: current viewpoint.

BACKGROUND: Umbilical metastases from a malignant neoplasm, also termed Sister Mary Joseph's nodule, are not commonly reported in the English literature, and they have usually been considered as a sign of a poor prognosis for the patient. The present article reports on the current view point on umbilical metastasis besides discussing the epidemiology, clinical presentation, pathophysiology and treatment. METHOD: A search of Pubmed was carried out using the term 'umblic*' and 'metastases' or metastasis' revealed no references. Another search was made using the term "Sister Joseph's nodule" or sister Joseph nodule" that revealed 99 references. Of these there were 14 review articles, however when the search was limited to English language it yielded only 20 articles. Articles selected from these form the basis of this report along with cross references. RESULTS: The primary lesions usually arise from gastrointestinal or genitourinary tract malignancies and may be the presenting symptom or sign of a primary tumour in an unknown site. CONCLUSION: A careful evaluation of all umbilical lesions, including an early biopsy if appropriate, is recommended. Recent studies suggest an aggressive surgical approach combined with chemotherapy for such patients may improve survival.