Descriptive observational study on the use of virtual reality in patients with inflammatory bowel disease undergoing biological treatment.

BACKGROUND: Virtual reality (VR) is a neurosensory experience in which simulated spaces a person has the sensation of being able to function within them. Some patients with inflammatory bowel disease (IBD) receive intravenous biological treatments in an Adult Day Hospital (ADH) regime. VR has been used in some fields of medicine, demonstrating its usefulness in reducing negative symptoms. However, we do not have any literature showing the applicability in real clinical practice of VR in IBD. METHODS: Descriptive observational pilot study based on an initial cohort of 87 patients that were obtained from the ADH of the IBD Unit. Satisfaction and acceptance of VR through the use of 3D glasses and the reduction of negative symptoms during intravenous biological treatment in patients with IBD in ADH have been assessed. RESULTS: 43 patients (52.4%) used VR and completed the study. In the comparative analysis of the results of the questionnaires before and after the use of VR, a statistically significant improvement was observed in the patients' view on the ability of VR to achieve a reduction in stress (65% patients improve; p: 0.0021) and pain (VAS, 54% p. improve; p<0.05) during treatment. Likewise, with the applicability of VR in other areas of medicine (53%; p: 0.05) and with the possibility of improving well-being during the stay in the ADH (56%; p: 0.0014). No side effects were reported with the use of the 3D glasses. CONCLUSIONS: VR is a useful complementary tool to improve the stay of patients with IBD on ADH during intravenous treatment.

Mesalazine-induced esophageal ulcers. a rare adverse effect.

31-year-old woman. Diagnosis of ulcerative proctitis in February/2022. Calprotectin 1832 µg/g. Colonoscopy: erythematous, friable and erosive mucosa up to 10 cm from the anal margin. Pathology: compatible with ulcerative colitis with moderate activity. Start of oral mesalazine (3 gr/24 h granules) and topical (1 gr/24 h suppository). After three months, she achieved clinical remission. Calprotectin 57 µg/g. Two months later, she consulted for solid dysphagia, loss of 10 kg, and low-grade fever for a month. Fifteen days before, she went to an emergency room where Prednisone 50 mg/24 h was started. On the day of the assessment, she was receiving 30 mg with no improvement. The next day, gastroscopy showed 6-12 mm esophageal ulcers with non-confluent shallow geographic borders, biopsies were taken. Viral serologies and HLA B51 were requested. Given the severity of the symptoms, empirical treatment was started with Valaciclovir 1 g/12 h. Serologies: IgG for Ebstein Barr virus, cytomegalovirus and herpes virus with negative IgM. Cytomegalovirus viral load: <30 IU/ml. Pathology: acute extensively ulcerated esophagitis, inflammatory infiltrate and some eosinophils with negative histochemical staining for fungi, cytomegalovirus and herpes virus I and II. HLA B51 was negative. Valaciclovir and mesalazine are discontinued after seven days given the known relationship of the latter with low-grade fever and, exceptionally, with esophageal pathology. Three days later, the patient reported clear improvement in dysphagia from the day the mesalazine was discontinued. After eight months, she was still asymptomatic. Upon resolution of the symptoms, control gastroscopy was not performed, and mesalazine has not been reintroduced due to its probable causal association. Mesalazine has an excellent safety profile. Adverse effects include fever, headache, diarrhea and.

Histiocytic sarcoma of the esophagus.

A 20-year-old male with no medical history of interest who goes to the emergency room because of retrosternal pain, odynophagia, dysphagia, and fever. On physical examination: 37.7ºC axillary temperature, bad general condition, and central chest pain on palpation. In the blood test: 16,200x10^6/L white blood cells, 12,800x10^6/L neutrophils, and 11.66mg/dL C reactive protein, with the rest of the complete blood count, coagulation, and biochemistry within normal values.

Analysis of the spatial distribution of the serve and the type of serve-return in elite table tennis. Sex differences.

Serve and return of the serve are among the most critical technical-tactical factors influencing performance in table tennis (TT). The present study aimed to analyse sex differences in the spatial distribution of serve and serve-return in elite TT players. A total of 48 elite TT players (men: n = 24; women: n = 24) participated in the investigation. A total of 24 matches were recorded and examined, analysing 1,177 plays and 5,319 strokes in the men's competition and 950 games and 5,097 strokes in the women's competition. Technical actions were analysed using an observation tool validated by two expert TT coach with a high level of agreement (K > 0.80). Men distributed their serves over zones 1 and 2 of the table, while women more frequently selected zone 5 (p < 0.05). In men, 30.1% of the serves were near the net, 63.6% in the middle zone of the table and 6.2% in the end zone of the table, while in women, these values were 10.9%, 67.2%, and 21.8%, respectively. As for the technique of the serve-return depending on the zone of the service, in men the action of the cut from zone 1 and 2 predominated, while in women this technique was more frequent from zone 5 (p < 0.05). On the other hand, the serve-return with the flip technique in zone 1, 3 and 4 was more frequent in men (p < 0.05). As for the return of the serve with the topspin technique, there were differences in zone 3, being more frequent in men (p < 0.05). Finally, the serve return with cut and defensive serve-return techniques in zones 3, 4, 5, and 6 were more frequent in women (p < 0.05). There are differences between sexes in service and return of serve actions during a match in elite players.

768-km Multi-Stage Ultra-Trail Case Study-Muscle Damage, Biochemical Alterations and Strength Loss on Lower Limbs.

A series of case studies aimed to evaluate muscular fatigue in running a 768-km ultra-trail race in 11 days. Four non-professional athletes (four males) were enrolled. Muscle damage blood biomarkers (creatine kinase (CK), lactodeshydrogenase (LDH), aspartate transaminase (AST) and alanine aminotransferase (ALT) and lower limb strength were evaluated by using Bosco jumps test; squat jump (SJ), countermovement jump (CMJ) and Abalakov jump (ABA) were assessed before (pre), after the race (post) and for two and nine days during the recovery period (rec2 and rec9), respectively. Results showed: pre-post SJ = -28%, CMJ = -36% and ABA = -21%. Values returned to basal during rec9: SJ = -1%, CMJ = -2% or even exceeded pre-values ABA = +3%. On the contrary, muscle damage blood biomarkers values increased at post; CK = +888%, LDH = +172%, AST = +167% and ALT = +159% and the values returned gradually to baseline at rec9 except for AST = +226% and ALT = +103% which remained higher. Nonparametric bivariate Spearman's test showed strong correlations (Rs ≥ 0.8) between some jumps and muscle damage biomarkers at post (SJ-LDH Rs = 0.80, SJ-AST Rs = 0.8, ABA-LD H Rs = 0.80 and ABA-AST Rs = 0.80), at rec2 (SJ-CK Rs = 0.80 and SJ-ALT Rs = 0.80) and even during rec9 (ABA-CK). Similarly, some parameters such as accumulated elevation and training volume showed a strong correlation with LDH values after finishing the ultra-trail race. The alteration induced by completing an ultra-trail event in the muscle affects lower limb strength and may in some circumstances result in serious medical conditions including post- exertional rhabdomyolysis.

Extreme Ultra-Trail Race Induces Muscular Damage, Risk for Acute Kidney Injury and Hyponatremia: A Case Report.

A case study involving a healthy trained male athlete who completed a 786 km multi-stage ultra-trail race. Several markers were analyzed in blood and urine samples: creatinine (SCR) for kidney damage, sodium ([Na+]) for hyponatremia, creatine kinase (CK) for exertional rhabdomyolysis, as well as other hematological values. Samples were taken before and after the race and during the recovery period (days 2 and 9 after the race). Results showed: SCR = 1.13 mg/dl, [Na+] =139 mmol/l and CK = 1.099 UI/l. Criteria for the determination of acute kidney damage were not met, and [Na+] concentration was above 135 mEq/L, indicating the absence of hyponatremia. Exertional rhabdomyolysis was suffered by the athlete (baseline CK increased fivefold), though this situation was reverted after 9 days of recovery. Ultra-trail races cause biochemical changes in athletes, which should be known about by healthcare professionals.

Physiological Profile, Metabolic Response and Temporal Structure in Elite Individual Table Tennis: Differences According to Gender.

No research that has analyzed the structural characteristics, physiological profile, and energy demands in the game of table tennis as played by women is available. The present study aimed to evaluate the physiological, metabolic, and temporal variables of table tennis players and to observe gender differences. Forty-eight elite table tennis players participated in this study: 24 men (25.3 ± 4.07 years) and 24 women (22.3 ± 3.8 years). During simulated competition, temporal structure, heart rate (HR), and lactate (LA) were evaluated. The maximum ergospirometric evaluations were performed in a laboratory. The total table tennis (TT) time and the total resting time (TRT) were longer for men (p < 0.05), but game density was higher for women (p < 0.05). During rallies, the real playing time (RPT) was longer for women, while the TRT was longer for men (p < 0.05). The maximum HR, minimum HR, and maximum LA concentrations were higher for men (p < 0.05). The obtained data reveal gender differences in the physiological, metabolic, structural, and temporal variables in table tennis players. The analysis of the studied variables could allow training sessions to be planned and organized according to table tennis players' gender.

Gender Differences in Neuromuscular, Haematological and Urinary Responses during Padel Matches.

Research on the acute physiological response to a padel match is limited. The present study aimed to: (a) evaluate neuromuscular, urinary, and hematological responses after simulated padel competition (SC) and (b) analyze possible gender differences. In this study, 28 high-level padel players participated (men = 13, age = 26.83 ± 6.57 years; women = 15, age = 30.07 ± 4.36 years). The following parameters were analyzed before and after SC: neuromuscular (hand grip strength, squat jump (SJ), countermovement jump (CMJ), and Abalakov jump (ABK)), hematological (red blood cells, hemoglobin, and hematocrit), and urinary (pH, specific gravity, microalbuminuria, and red blood cells). Significant gender differences were found in neuromuscular and hematological responses, with men obtaining higher values (p < 0.05). For the SC influence, changes were noted in ABK and microalbuminuria (p < 0.05). The percentages of change in hand grip strength, SJ (height and watts), CMJ (height), and ABK (height) were higher for men than women (p < 0.05). SC negatively influenced the neuromuscular parameters to a greater extent in women. Our results could be related to gender differences in game actions, the temporal structure, and anthropometric and physiological characteristics. Game dynamics and a different organic response between male and female padel playing were confirmed.

Effects of Ultratrail Running on Neuromuscular Function, Muscle Damage and Hydration Status. Differences According to Training Level.

The status of trail running races has exponentially grown in recent years. The present study aimed to: (a) evaluate the acute response of ultratrail racing in terms of neuromuscular function, muscle damage and hydration status; (b) analyze if responses could differ according to training levels. Twenty runners participated in the present study. The participants were divided into amateur training level (n = 10; 43.30 ± 4.52 years) or high level competitors (n = 10; 41.40 ± 6.18). Neuromuscular response (squat jump, countermovement jump and Abalakov jump), muscle damage (alanine aminotransferase, bilirubin, creatine kinase and leukocytes) and hydration status (sodium and creatinine) were evaluated before and after the Guara Somontano Ultratrail Race (108 km distance, with an accumulated slope of 5800 m). The height and power achieved by vertical jumps were lower after the race (p < 0.001). The post-race muscle damage and creatinine parameters increased in both groups (p < 0.001). The high-level group obtained lower percentages of change in squat jump and countermovement jump than the amateur-level group (p < 0.05). However, the increase in creatinine was greater for the high-level group (p < 0.05). Ultratrail racing reduces neuromuscular function and increases muscle damage. High-level runners showed less neuromuscular fatigue compared to amateur ones.

Effects of Power and Ballistic Training on Table Tennis Players' Electromyography Changes.

The aim of the present study was to analyze the effects of ballistic and power training on table tennis players' electromyography (EMG) changes. Thirty male table tennis players, who were able to perform top spin strikes properly, were randomly assigned to three groups: power training (PT; n = 10); ballistic training (BT; n = 10); and no training (CON = control group; n = 10). PT and BT were performed 3 times weekly for 8 weeks. Before and after training programs, a one-repetition maximum test (1RM) and the EMG activity of all the subjects' upper/lower body muscles while performing top spin strokes were analyzed. After training, significant interactions (group × time) were observed in increasing 1RM strength in upper/lower muscles (p < 0.05). However, neither training type had any significant effect on muscle EMG activity. These findings suggest that there should not necessarily be any significant change in the EMG signal after BT and PT despite the increase in muscle strength.

[Cost-effectiveness analysis of two strategies for malaria control in the urban area of Buenaventura, Colombia]. / Análisis de costo-efectividad de dos intervenciones para el control de la malaria en el área urbana de Buenaventura, Colombia.

INTRODUCTION: Costs and results of two alternatives for malaria control were compared. One constituted by the activities of the National Programme, the other by the integration of an educational strategy denominated "Integrated Alternative" (IA) into the national program in Buenaventura on the Pacific Coast of Colombia. Objective. To evaluate the cost-effectiveness of two alternatives for malaria control in the urban area of Buenaventura. MATERIALS AND METHODS. A cost-effectiveness analysis was carried out from an institutional and household perspective. Institutional costs were obtained by reviewing records of institutions that implemented each alternative; household costs were obtained from interviews. Effectiveness measurement was the number of averted cases per 10,000 inhabitants. RESULTS: Institutional costs of National Programme and Integrated Alternative were U.S. dollars 3766 and U.S. dollars 24,932.8 respectively. Average household cost in the zone where National Programme was implemented was U.S. dollars 36.2, while in the zone where IA was applied it was U.S. dollars 28.4. The number of averted cases per 10,000 inhabitants was 12.9 (CI 95% -6.0; 31.8) for National Programme and 264.6 (CI 95% 254.1; 275.1) for Integrated Alternative. The institutional cost-effectiveness ratios of National Programme and Integrated Alternative were U.S. dollars 292.4 and U.S. dollars 92.2, respectively. CONCLUSION: Integration of the educational strategy into the National Programme was the most cost-effective alternative. Our data suggest that the educational strategy should be added to the National Programme activities.