Legionellers' desease accounts for 1-8 % of cases of severe community-acquired pneumonia (CAP). Legionella spp. Is the causative organism that can result in respiratory failure, multi-organ dysfunction, sepsis, and death. Therefore, rapid diagnosis and efficient treatment are crucial. We report the clinical and microbiology study of a patient with community-acquired pneumonia caused by Legionella pneumophila, with fatal outcome. After death, the strain causing the infection was identified as Legionella pneumophila serogroup 1, Olda OLDA phenotype and sequence-type 1. This is the first reported case of septic shock and death associated with an isolate of these characteristics.
Fast- and slow-growing phenotypes from two separate breeding families of the Manila clam (Ruditapes philippinarum) were alternatively fed two monoalgal diets with high and low N content (C:N ratios of 4.9 and 13.5, respectively). After 35 days of food conditioning, clams were sacrificed, and the soft body was dissected out into five different tissue fractions to determine the corresponding ponderal ratios (tissue wt./body wt.) and a separate analysis of the elemental composition of these tissues. Previously reported C and N balances performed with the same conditioning diets were integrated and compared with tissue composition of the same phenotypes in order to assess the efficacy of mechanisms elicited to compensate for N deficit. Broad differences in dietary N content resulted in only minor changes in whole-body C:N composition which suggests a noticeable degree of homeostatic regulation of nutrient balances. This regulation was found to be stricter in fast-compared to slow-growing phenotypes and differed among the various body tissues. Using the threshold element ratio approach, physiological mechanisms were identified that partly compensate for large stoichiometric mismatches between low-N food and body tissues.
Bivalvia , Animals , Phenotype , Bivalvia/physiology , Seafood , Body Composition , Homeostasis , Nutrients
BACKGROUND AND OBJECTIVE: the use of 3D cameras for gait analysis has been highly questioned due to the low accuracy they have demonstrated in the past. The objective of the study presented in this paper is to improve the accuracy of the estimations made by robot-mounted 3D cameras in human gait analysis by applying a supervised learning stage. METHODS: the 3D camera was mounted in a mobile robot to obtain a longer walking distance. This study shows an improvement in detection of kinematic gait signals and gait descriptors by post-processing the raw estimations of the camera using artificial neural networks trained with the data obtained from a certified Vicon system. To achieve this, 37 healthy participants were recruited and data of 207 gait sequences were collected using an Orbbec Astra 3D camera. There are two basic possible approaches for training and both have been studied in order to see which one achieves a better result. The artificial neural network can be trained either to obtain more accurate kinematic gait signals or to improve the gait descriptors obtained after initial processing. The former seeks to improve the waveforms of kinematic gait signals by reducing the error and increasing the correlation with respect to the Vicon system. The second is a more direct approach, focusing on training the artificial neural networks using gait descriptors directly. RESULTS: the accuracy of the 3D camera to objectify human gait was measured before and after training. In both training approaches, a considerable improvement was observed. Kinematic gait signals showed lower errors and higher correlations with respect to the ground truth. The accuracy of the system to detect gait descriptors also showed a substantial improvement, mostly for kinematic descriptors rather than spatio-temporal. When comparing both training approaches, it was not possible to define which was the absolute best. CONCLUSIONS: supervised learning improves the accuracy of 3D cameras but the selection of the training approach will depend on the purpose of the study to be conducted. This study reveals the great potential of 3D cameras and encourages the research community to continue exploring their use in gait analysis.
Backstroke swimmers display the greatest contribution of underwater kicking during the swimming race distances, but, surprisingly, there is little evidence of how kicking kinematics in the dorsal position should be performed. The aim of the present study was to examine the kinematic characteristics of competitive swimmers during underwater undulatory swimming in the dorsal position, with special attention to the swimmers' gender, the level of skill, and kick order. Forty-one national-level swimmers (27 females and 14 males) were filmed from an underwater lateral view while performing a 25-m backstroke from a push start, and they were divided into fast and slow groups according to their kicking velocity. Direct linear algorithms were employed to reconstruct the two-dimensional kinematic characteristics of the first and final kicks of the underwater section. There were no differences between males and females in kicking performance when data were normalised to the swimmers' height. However, swimmers in the fast-kicking group were distinguished by a greater kicking frequency (η2: 0.15) and specific segmental kinematics related to a lower knee range of motion. Swimmers decreased kicking velocity (η2: 0.47) in addition to the kicking frequency (η2: 0.31) and length (η2: 0.16), but increased the kicking amplitude (η2: 0.11) between the first and the final kicks. Changes in kicking segmental kinematics were more related to modification in body orientation during the underwater trajectory than to the kicking motion itself. These results provide the first solid evidence of how swimmers should kick for better performance in dorsal underwater swimming.
At present, the applications and efficacy of non-ionizing radiations (NIR) in oncotherapy are limited. In terms of potential combinations, the use of biocompatible magnetic nanoparticles as heat mediators has been extensively investigated. Nevertheless, developing more efficient heat nanomediators that may exhibit high specific absorption rates is still an unsolved problem. Our aim was to investigate if externally applied magnetic fields and a heat-inducing NIR affect tumor cell viability. To this end, under in vitro conditions, different human cancer cells (A2058 melanoma, AsPC1 pancreas carcinoma, MDA-MB-231 breast carcinoma) were treated with the combination of electromagnetic fields (EMFs, using solenoids) and hyperthermia (HT, using a thermostated bath). The effect of NIR was also studied in combination with standard chemotherapy and targeted therapy. An experimental device combining EMFs and high-intensity focused ultrasounds (HIFU)-induced HT was tested in vivo. EMFs (25 µT, 4 h) or HT (52 °C, 40 min) showed a limited effect on cancer cell viability in vitro. However, their combination decreased viability to approximately 16%, 50%, and 21% of control values in A2058, AsPC1, and MDA-MB-231 cells, respectively. Increased lysosomal permeability, release of cathepsins into the cytosol, and mitochondria-dependent activation of cell death are the underlying mechanisms. Cancer cells could be completely eliminated by combining EMFs, HT, and standard chemotherapy or EMFs, HT, and anti-Hsp70-targeted therapy. As a proof of concept, in vivo experiments performed in AsPC1 xenografts showed that a combination of EMFs, HIFU-induced HT, standard chemotherapy, and a lysosomal permeabilizer induces a complete cancer regression.
Audio frequency magnetic fields (20 Hz-20 kHz) are magnetic fields in extremely low frequency-very low frequency (ELF-VLF) bands that are present near audio equipment and acoustic transducers. These devices transform and operate the electrical signal from the recordings or other devices into acoustic and audio signals. The cognitive influence of sound and noise has been widely studied and recognized since the times of ancient Rome; however, the cognitive effects of the magnetic fields of these frequencies have not been studied. Due to the extensive use of audio devices that use this type of transducer near the temporal-parietal area, we believe that it is of interest to study their impact on short-term memory or working memory (WM) and to analyze their potential as they operate as a transcranial magnetic stimulation. In this study, a mathematical model and an experimental tool are introduced to analyze memory performance. The model dissociates the reaction time of a cognitive task. We analyze the model in data from a group of 65 young, healthy subjects. WM is assessed in our experimental setup by means of the Sternberg test (ST), whereby during the ST, one subgroup was exposed to an audio frequency magnetic stimulus, and the other subgroup received a sham stimulus. The magnetic stimulus was ~0.1 µT and was applied to both sides of the head at the frontal cortex near the temporal-parietal area, which is where WM is expected to be located. The ST records reaction times when determining whether an object displayed on the computer screen is one of the objects to be remembered. The results are analyzed within the mathematical model and changes are observed, including the deterioration of WM, which could affect 32% of its operability.
The contribution to total race distances of underwater undulatory swimming (UUS) is increasing at the elite level. However, little is known about the technical modifications during underwater swimming. In the present research, the aim was to compare the kinematic characteristics of competitive swimmers between the first and last kick of UUS. Fifty-four national level swimmers (26 males and 28 females) performed 25 m maximal efforts from a push start, and two sequential video cameras captured the underwater segment. Kicking parameters and segmental kinematics were calculated by means of two-dimensional direct linear transformation algorithms. Dolphin kick performance showed a clear impairment in velocity (η2 : 0.65), but changes on kicking parameters depended on the swimmer's gender, with males decreasing kicking amplitude (η2 : 0.25) and females decreasing kicking frequency (η2 : 0.18) in the last kick. Decline in kicking performance seemed to be more related to the swimmers' body configuration when approaching the water surface (greater trunk inclination and maximal body amplitude in sagittal plane) than to technical modifications in the dolphin kick movement (no changes in the joints range of movement except the hip). Swimmers should control their vertical body amplitude at the end of underwater sections to minimise the decrease in kicking performance.
BACKGROUND: There is a considerable need to incorporate biomarkers of resistance to new antiandrogen agents in the management of castration-resistant prostate cancer (CRPC). METHODS: We conducted a phase II trial of enzalutamide in first-line chemo-naïve asymptomatic or minimally symptomatic mCRPC and analyzed the prognostic value of TMPRSS2-ERG and other biomarkers, including circulating tumor cells (CTCs), androgen receptor splice variant (AR-V7) in CTCs and plasma Androgen Receptor copy number gain (AR-gain). These biomarkers were correlated with treatment response and survival outcomes and developed a clinical-molecular prognostic model using penalized cox-proportional hazard model. This model was validated in an independent cohort. RESULTS: Ninety-eight patients were included. TMPRSS2-ERG fusion gene was detected in 32 patients with no differences observed in efficacy outcomes. CTC detection was associated with worse outcome and AR-V7 in CTCs was associated with increased rate of progression as best response. Plasma AR gain was strongly associated with an adverse outcome, with worse median prostate specific antigen (PSA)-PFS (4.2 vs. 14.7 m; p < 0.0001), rad-PFS (4.5 vs. 27.6 m; p < 0.0001), and OS (12.7 vs. 38.1 m; p < 0.0001). The clinical prognostic model developed in PREVAIL was validated (C-Index 0.70) and the addition of plasma AR (C-Index 0.79; p < 0.001) increased its prognostic ability. We generated a parsimonious model including alkaline phosphatase (ALP); PSA and AR gain (C-index 0.78) that was validated in an independent cohort. CONCLUSIONS: TMPRSS2-ERG detection did not correlate with differential activity of enzalutamide in first-line mCRPC. However, we observed that CTCs and plasma AR gain were the most relevant biomarkers.
Neoplastic Cells, Circulating , Prostatic Neoplasms, Castration-Resistant , Humans , Male , Biomarkers, Tumor/genetics , Neoplastic Cells, Circulating/pathology , Nitriles/therapeutic use , Prognosis , Prostate-Specific Antigen , Prostatic Neoplasms, Castration-Resistant/drug therapy , Prostatic Neoplasms, Castration-Resistant/genetics , Prostatic Neoplasms, Castration-Resistant/pathology , Receptors, Androgen/genetics
The first complete upper and lower limbswimming cycle after the underwater segment of start and turns represents the breakout phase in competitive swimming. The aim of the present research was to examine the effect of the breakout movements on the stroking variables and coordinative patterns of competitive swimmers. Thirty-three national-level male swimmers performed 4 x 25 m maximal efforts (one of each stroke in random order) from a push start and were recorded by two sequential cameras in the sagittal plane. The average velocity, stroke length, and stroke frequency; the relative duration (%) of the stroke phases; and the inter-limb discrete relative phases were calculated using direct linear transformation algorithms for the breakout and free-swimming phases. In general terms, swimming velocity during breakout was faster (δ 0.27 ± 0.04 m/s, p < 0.001, ES = 0.33) than free swimming (in all strokes but breaststroke), not because of a faster previous underwater kicking or a modified coordinative swimming pattern, but because of an increase in the stroke rate (δ 4.68 ± 0.79 cycles/min, p < 0.001, ES = 0.36). These results indicate how swimmers manage the changing constraints during breakout from underwater to surface swimming.
Movement , Swimming , Humans , Male , Biomechanical Phenomena , Extremities
Body-size scaling of metabolic rate in animals is typically allometric, with mass exponents that vary to reflect differences in the physiological status of organisms of both endogenous and environmental origin. Regarding the intraspecific analysis of this relationship in bivalve molluscs, one important source of metabolic variation comes from the large inter-individual differences in growth performance characteristic of this group. In the present study, we aimed to address the association of growth rate differences recorded among individual mussels (Mytilus galloprovincialis) with variable levels of the standard metabolic rate (SMR) resulting in growth-dependent shift in size scaling relationships. SMR was measured in mussels of different sizes and allometric functions fitting SMR vs. body-mass relationships were compared both inter- and intra-individually. The results revealed a metabolic component (the overhead of growth) attributable to the differential costs of maintenance of feeding and digestion structures between fast and slow growers; these costs were estimated to amount to a 3% increase in SMR per unit of increment in the weight specific growth rate. Scaling exponents computed for intraindividual SMR vs body-mass relationships had a common value b = 0.79 (~ ¾); however, when metabolic effects caused by differential growth were discounted, this value declined to 0.67 (= â ), characteristic of surface dependent processes. This last value of the scaling exponent was also recorded for the interindividual relationships of both standard and routine metabolic rates (SMR and RMR) after long-lasting maintenance of mussels under optimal uniform conditions in the laboratory. The above results were interpreted based on the metabolic level boundaries (MLB) hypothesis.
Basal Metabolism , Mytilus , Animals , Basal Metabolism/physiology , Body Size , Energy Metabolism/physiology , Mytilus/physiology
This study used principal component analysis (PCA) of waveforms to extract movement patterns from hip and knee angle time-series data; and determined if the extracted movement patterns were predictors of ball velocity during a soccer kick. Twenty-three female and nineteen male professional soccer players performed maximal effort instep kicks while motion capture and post-impact ball velocities data were recorded. Three-dimensional hip and knee joint angle time-series data were calculated from the beginning of the kicking leg's backswing phase until the end of the follow-through phase and entered into separate PCAs for females and males. Three principal components (PC) (i.e., movement patterns) were extracted and PC scores were calculated. Pearson correlation coefficients were calculated to establish correlations between hip and knee PC scores and kicking velocity. Results showed better kicking performance in male players was associated with a greater difference between the hip extension at the end of the backswing/beginning of the leg cocking phases and hip flexion at the end of the follow-through phase (r = -0.519, p = 0.023) and a delayed internal rotation of the hip (r = 0.475, p = 0.040). No significant correlations between ball velocity and hip and knee kinematics were found for female players.
Soccer , Humans , Male , Female , Hip , Principal Component Analysis , Knee Joint , Biomechanical Phenomena
Microplastics (MPs) can adsorb persistent organic pollutants such as oil hydrocarbons and may facilitate their transfer to organisms (Trojan horse effect). The aim of this study was to examine the effects of a 21 day dietary exposure to polystyrene MPs of 4.5 µm at 1000 particles/mL, alone and with sorbed oil compounds from the water accommodated fraction (WAF) of a naphthenic North Sea crude oil at two dilutions (25 % and 100 %), on marine mussels. An additional group of mussels was exposed to 25 % WAF for comparison. PAHs were accumulated in mussels exposed to WAF but not in those exposed to MPs with sorbed oil compounds from WAF (MPs-WAF), partly due to the low concentration of PAHs in the studied crude oil. Exposure to MPs or to WAF alone altered the activity of enzymes involved in aerobic (isocitrate dehydrogenase) and biotransformation metabolism (glutathione S-transferase). Prevalence of oocyte atresia and volume density of basophilic cells were higher and absorption efficiency lower in mussels exposed to MPs and to WAF than in controls. After 21 days MPs caused DNA damage (Comet assay) in mussel hemocytes. In conclusion, a Trojan horse effect was not observed but both MPs and oil WAF caused an array of deleterious effects on marine mussels at different levels of biological organization.
Mytilus , Petroleum , Water Pollutants, Chemical , Animals , Microplastics , Petroleum/toxicity , Petroleum/metabolism , Plastics/toxicity , Plastics/metabolism , Polystyrenes/metabolism , Water/metabolism , Persistent Organic Pollutants , North Sea , Isocitrate Dehydrogenase/metabolism , Isocitrate Dehydrogenase/pharmacology , Water Pollutants, Chemical/analysis , Glutathione Transferase/metabolism
This study investigates the contribution of external trunk morphology and posture to running performance in an evolutionary framework. It has been proposed that the evolution from primitive to derived features of torso shape involved changes from a mediolaterally wider into a narrower, and antero-posteriorly deeper into a shallower, more lightly built external trunk configuration, possibly in relation to habitat-related changes in locomotor and running behaviour. In this context we produced experimental data to address the hypothesis that medio-laterally narrow and antero-posteriorly shallow torso morphologies favour endurance running capacities. We used 3D geometric morphometrics to relate external 3D trunk shape of trained, young male volunteers (N = 27) to variation in running velocities during different workloads determined at 45-50%, 70% and 85% of heart rate reserve (HRR) and maximum velocity. Below 85% HRR no relationship existed between torso shape and running velocity. However, at 85% HRR and, more clearly, at maximum velocity, we found highly statistically significant relations between external torso shape and running performance. Among all trained subjects those with a relatively narrow, flat torso, a small thoracic kyphosis and a more pronounced lumbar lordosis achieved significantly higher running velocities. These results support the hypothesis that external trunk morphology relates to running performance. Low thoracic kyphosis with a flatter ribcage may affect positively respiratory biomechanics, while increased lordosis affects trunk posture and may be beneficial for lower limb biomechanics related to leg return. Assuming that running workload at 45-50% HRR occurs within aerobic metabolism, our results may imply that external torso shape is unrelated to the evolution of endurance running performance.
Hominidae , Kyphosis , Lordosis , Running , Animals , Biomechanical Phenomena , Humans , Male , Running/physiology , Torso/physiology
Mobile robotic platforms have made inroads in the rehabilitation area as gait assistance devices. They have rarely been used for human gait monitoring and analysis. The integration of mobile robots in this field offers the potential to develop multiple medical applications and achieve new discoveries. This study proposes the use of a mobile robotic platform based on depth cameras to perform the analysis of human gait in practical scenarios. The aim is to prove the validity of this robot and its applicability in clinical settings. The mechanical and software design of the system is presented, as well as the design of the controllers of the lane-keeping, person-following, and servoing systems. The accuracy of the system for the evaluation of joint kinematics and the main gait descriptors was validated by comparison with a Vicon-certified system. Some tests were performed in practical scenarios, where the effectiveness of the lane-keeping algorithm was evaluated. Clinical tests with patients with multiple sclerosis gave an initial impression of the applicability of the instrument in patients with abnormal walking patterns. The results demonstrate that the system can perform gait analysis with high accuracy. In the curved sections of the paths, the knee joint is affected by occlusion and the deviation of the person in the camera reference system. This issue was greatly improved by adjusting the servoing system and the following distance. The control strategy of this robot was specifically designed for the analysis of human gait from the frontal part of the participant, which allows one to capture the gait properly and represents one of the major contributions of this study in clinical practice.
Gait Disorders, Neurologic , Robotic Surgical Procedures , Robotics , Biomechanical Phenomena , Gait , Gait Analysis , Humans , Walking
INTRODUCTION: Nonsuicidal self-injury (NSSI) and suicidal behavior (SB) have a significant prevalence in transsexual people. The published data is confusing as it does not distinguish between ideation and realization, age groups, gender, or the degree of medical intervention. Their actual prevalence in Spain is unknown. OBJECTIVE: Our objective was to investigate the prevalence of NSSI behavior and SB in adolescents and young transsexual adults, differentiating between ideation and consummated behavior, prior to their receiving any type of gender-affirming medical treatment. MATERIAL AND METHODS: We retrospectively reviewed the medical history of a cohort of transsexual people aged between 10 and 35 years, treated at the Gender Identity Unit of the Valencian Community. We analyzed the data collected regarding the presence of four variables: NSSI ideation, NSSI behavior, ideas of suicide and suicide attempts, as well as differences according to age group and gender. RESULTS: The final sample consisted of 110 transsexual men and 90 transsexual women. Of these, 21% had made a suicide attempt, 50% had had suicidal ideas, 31% had a history of NSSI behavior and 35% had had NSSI ideas. No differences were found based on gender. Regarding age, subjects under 20 years of age presented a significantly higher prevalence regarding suicidal ideas compared to young adults (43% vs. 25%), while in the remaining variables, no statistically significant differences were found. CONCLUSIONS: The prevalence of a history of suicidal ideas and behavior in the Spanish adolescent and young transsexual population is significant and does not differ according to gender or age range. The prevalence of NSSI ideas and behavior differs and is more frequent in adolescent transsexuals.
Self-Injurious Behavior , Suicidal Ideation , Transgender Persons/psychology , Adolescent , Adult , Child , Female , Gender Identity , Humans , Male , Retrospective Studies , Risk Factors , Self-Injurious Behavior/epidemiology , Spain/epidemiology , Young Adult
Las lesiones tumorales de localización parafaríngea presentan una escasa incidencia, representando entre el 0,5 y el 0,8% de todas las tumoraciones de cabeza y cuello. Aproximadamente el 80% presentan un comportamiento benigno. La singularidad de dichas lesiones deriva de su compleja situación anatómica y de la clínica con la que suelen debutar, siendo en la mayoría de los casos inespecífica y casi siempre derivada del efecto compresivo producido por la lesión sobre la oro y rinofaringe. Los Schwannoma del espacio parafaríngeo son tumores muy infrecuentes, que se originan de la vaina de schawnn, generalmente de crecimiento lento, suelen ser asintomáticos. El tratamiento es quirúrgico, muchas veces complejo por la localización anatómica. Se presenta el caso de una paciente femenina de 42 años de edad con diagnóstico de Schwannoma en la región parafaríngea izquierda demostrada mediante biopsia incisional; realizándosele tratamiento quirúrgico, el cual se llevó a cabo sin complicaciones.
Parapharyngeal tumor lesions present a low incidence, representing between 0,5 and 0,8% of all head and neck tumors. Approximately 80% show benign behavior. The uniqueness of these lesions derives from their complex anatomical situation and the symptoms with which they usually appear, being in most cases nonspecific and almost always derived from the compressive effect produced by the lesion on the oropharynx and the oropharynx. Schwannomas of the parapharyngeal space are very rare tumors that originate from the sheath of schawnn, generally slow growing, and are usually asymptomatic. Treatment is surgical, often complex due to the anatomical location. The case of a 42-year-old female patient with a diagnosis of Schwannoma in the left parapharyngeal region, demonstrated by incisional biopsy, is presented; undergoing surgical treatment, which was carried out without complications.
Coronavirus disease 2019 (COVID-19) is currently the major public health problem worldwide. Neutral electrolyzed saline solution that contains reactive chlorine and oxygen species may be an effective therapeutic. In the present study, the treatment efficacy of intravenous and/or nebulized neutral electrolyzed saline combined with usual medical care vs. usual medical care alone was evaluated in ambulatory patients with COVID-19. A prospective, 2-arm, parallel-group, randomized, open-label, multi-center, phase I-II clinical trial including 214 patients was performed. The following two outcomes were evaluated during the 20-day follow-up: i) The number of patients with disease progression; and ii) the patient acceptable symptom state. Serial severe acute respiratory syndrome coronavirus 2 naso/oro-pharyngeal detection by reverse transcription-quantitative (RT-q) PCR was performed in certain patients of the experimental group. Biochemical and hematologic parameters, as well as adverse effects, were also evaluated in the experimental group. The experimental treatment decreased the risk of hospitalization by 89% [adjusted relative risk (RR)=0.11, 95% confidence interval (CI): 0.03-0.37, P<0.001] and the risk of death by 96% (adjusted RR=0.04, 95% CI: 0.01-0.42, P=0.007) and also resulted in an 18-fold higher probability of achieving an acceptable symptom state on day 5 (adjusted RR=18.14, 95% CI: 7.29-45.09, P<0.001), compared with usual medical care alone. Overall, neutral electrolyzed saline solution was better than usual medical care alone. Of the patients analyzed, >50% were negative for the virus as detected by RT-qPCR in naso/oro-pharyngeal samples on day 4, with only a small number of positive patients on day 6. Clinical improvement correlated with a decrease in C-reactive protein, aberrant monocytes and increased lymphocytes and platelets. Cortisol and testosterone levels were also evaluated and a decrease in cortisol levels and an increase in the testosterone-cortisol ratio were observed on days 2 and 4. The experimental treatment produced no serious adverse effects. In conclusion, neutral electrolyzed saline solution markedly reduced the symptomatology and risk of progression in ambulatory patients with COVID-19. The present clinical trial was registered in the Cuban public registry of clinical trials (RPCEC) database (May 5, 2020; no. TX-COVID19: RPCEC00000309).
The purpose of the present study was twofold: (i) to compare the kinematic characteristics of individual and relay swimming starts; and (ii) to relate the kinematic variables to 5 m performance for both starts. Twelve elite-level swimmers performed 2 × 25 m at maximal effort (one with an individual and one with a relay start randomly). Two-dimensional direct linear transformation algorithms were used to calculate swimmers' centre of mass (CM) kinematics during each subphase. The results indicated moderate to much faster 5 m, 10 m 15 and 15 m times (29.4, 10.7 and 6.5%) for relay than individual starts as well as the differences at specific parameters, but no differences in take-off horizontal velocity between start techniques. Large correlations to performance times were found in block time, horizontal take-off velocity, take-off velocity and entry angle (r = 0.77 to 0.83) 20 for individual start, but in changeover time, take-off height and entry distance (r = 0.69 to 0.90) for relay start. Differences on swim start regulations between individual and relay events were in line with different key parameters related to start performances in each event. This should be considered by swimmers and coaches when addressing the starting improvement.
Introducción: El neumomediastino es una patología poco frecuente y rara. Las manifestaciones radiológicas típicas en los pacientes en neumonía por SARS-CoV-2 consiste en la presencia de opacidades pulmonares bilaterales, de distribución periférica. En una reciente serie de pacientes con COVID-19 indica que el 1% de los pacientes pueden desarrollar neumomediastino espontáneo como complicación, generalmente es de curso benigno y no se aclara aún que ello puede suponer un indicador de agravamiento. Caso Clínico: Se trata de un paciente varón de 43 años que presentó un tiempo de enfermedad de 15 días caracterizado por dolor faríngeo, fiebre, dolor torácico y dificultad respiratoria, recibiendo múltiples esquemas de tratamiento tanto antiviral y antibióticos sin respuesta, por lo que acudió al Hospital Rebagliati donde se le encontró insuficiencia respiratoria, hipoxemia y sepsis. Su tomografía fue compatible con infiltrado en vidrio deslustrado, áreas de consolidación pulmonar bilateral y neumomediastino. No requirió tratamiento quirúrgico y evolucionó favorablemente a la neumonía con disminución de marcadores inflamatorios y remisión de neumomediastino en control tomográfico. Conclusión: Este reporte resalta que en la infección por COVID-19 las complicaciones pulmonares a tener en cuenta son la neumonía bilateral, coinfección bacteriana, sepsis y neumomediastino espontáneo.
Introduction: Pneumomediastinum is an infrequent and rare pathology. The typical radiological manifestations in patients with SARS-CoV-2 pneumonia consist of the presence of bilateral pulmonary opacities, of peripheral distribution. In a recent series of patients with COVID-19, it indicates that 1% of patients can develop spontaneous pneumomediastinum as a complication, it is generally benign and it is not yet clear that this may be an indicator of worsening. Clinical Case: This is a 43-year-old male patient who presented a 15-day illness characterized by pharyngeal pain, fever, chest pain and respiratory distress, receiving multiple antiviral and antibiotic treatment schemes without response, for which he attended to Rebagliati Hospital where he was found respiratory failure, hypoxemia and sepsis. His tomography was compatible with ground glass infiltrate, areas of bilateral lung consolidation, and pneumomediastinum. It did not require surgical treatment and it evolved favorably to pneumonia with a decrease in inflammatory markers and remission of pneumomediastinum in tomographic control. Conclusion: This report highlights that in COVID-19 infection the pulmonary complications to take into account are bilateral pneumonia, bacterial coinfection, sepsis and spontaneous pneumomediastinum.
INTRODUCTION: Nonsuicidal self-injury (NSSI) and suicidal behavior (SB) have a significant prevalence in transsexual people. The published data is confusing as it does not distinguish between ideation and realization, age groups, gender, or the degree of medical intervention. Their actual prevalence in Spain is unknown. OBJECTIVE: Our objective was to investigate the prevalence of NSSI behavior and SB in adolescents and young transsexual adults, differentiating between ideation and consummated behavior, prior to their receiving any type of gender-affirming medical treatment. MATERIAL AND METHODS: We retrospectively reviewed the medical history of a cohort of transsexual people aged between 10 and 35 years, treated at the Gender Identity Unit of the Valencian Community. We analyzed the data collected regarding the presence of four variables: NSSI ideation, NSSI behavior, ideas of suicide and suicide attempts, as well as differences according to age group and gender. RESULTS: The final sample consisted of 110 transsexual men and 90 transsexual women. Of these, 21% had made a suicide attempt, 50% had had suicidal ideas, 31% had a history of NSSI behavior and 35% had had NSSI ideas. No differences were found based on gender. Regarding age, subjects under 20 years of age presented a significantly higher prevalence regarding suicidal ideas compared to young adults (43% vs. 25%), while in the remaining variables, no statistically significant differences were found. CONCLUSIONS: The prevalence of a history of suicidal ideas and behavior in the Spanish adolescent and young transsexual population is significant and does not differ according to gender or age range. The prevalence of NSSI ideas and behavior differs and is more frequent in adolescent transsexuals.
