Time-Course of Changes in Physiological, Psychological, and Performance Markers following a Functional-Fitness Competition.

Functional Fitness Training (FFT) programs are characterized by utilizing a high volume of training and using a variety of high intensity exercises. While FFT are growing in the number of practitioners and popularity, the relationship between physiological biomarkers and subjective scales in the specific context of FFT has not yet been evaluated in the literature. The purpose of the present study was to monitor the time-course response of cytokines (IL-10 and 1L-1ß), immune variables (C-reactive protein -CRP and immunoglobulin A-IgA), hormonal milieu (cortisol-C, total testosterone-TT, free testosterone-FT and testosterone/cortisol-T/C ratio), creatine kinase-CK, muscle performance (countermovement jump height) and perceived well-being (WB) following a functional fitness competition. Nine amateur male athletes (age 27.1 ± 4.1 years; training experience 2.2 ± 1.3 years) completed five workouts over three consecutive days of FFT-competition. All variables were measured before, 24 h, 48 h, and 72 h following the last day of competition. The FFT-competition induced a decrease in IL10/IL1ß ratio approximately 5% after 24h, 21% after 48h and 31% after 72h. Delta T/C ratio remained unchanged during the post-competition period. IgA displayed a significant increase 24h and 72h post FFT-competition. The WB status score was higher 72h after the FFT-competition as compared with pre-competition. The present findings suggest that FFT-competition induces transient changes in some inflammatory and hormonal biomarkers, and perceived well-being seems to be efficient to detect changes in muscle performance.

Validity of Session Rating Perceived Exertion Method for Quantifying Internal Training Load during High-Intensity Functional Training.

The aim of this study was to validate the quantification of internal training load (session rating perceived exertion, sRPE) and the effect of recall timing of sRPE during high-intensity functional training (HIFT) sessions. Thirteen male HIFT practitioners (age 27.2 ± 33 years, height 177.1 ± 4.0 cm, body mass 81.1 ± 9.0 kg) were monitored during two common HIFT training sessions: Fight Gone Bad (FGB) and Fran. The Edwards summated heart-rate-zone method was used as a reference measure of internal training load. The session-RPE rating was obtained using the CR-10 scale modified by Foster. The training load calculated by the Edwards-TRIMP index was significantly higher (p < 0.05) during the FGB (77.7 ± 4.9) than the Fran (19.8 ± 8.4) workout. There was a strong correlation (p < 0.05) between the Edwards-TRIMP index and the training load calculated by the sRPE in all time frames (0, 10, 20, and 30 min post-exercise). The RPE and sRPE measured at 30 min post-exercise time frame was significant lower than 0, 10, and 20 min post-exercise for both workouts. The session-RPE method is an easy and valid tool to evaluate internal training load for high intensity functional training practitioners.

Exertional Rhabdomyolysis after an Extreme Conditioning Competition: A Case Report.

This case report describes an instance of exercise-induced rhabdomyolysis caused by an extreme conditioning program (ECP) competition. A 35-year-old female presented with abdominal pain and soreness, which began one day after she completed two days of ECPcompetition composed of five workouts. Three days after competition, creatine kinase (CK) was 77,590 U/L accompanied by myalgia and abnormal liver function tests, while renal function was normal and this resulted in a diagnosis of rhabdomyolysis. A follow-up examination revealed that her serum level of CK was still elevated to 3034 U/L on day 10 and 1257 U/L on day 25 following the ECP competition. The subject reported myalgia even up to 25 days after the ECP competition. Exertional rhabdomyolysis can be observed in ECP athletes following competition and highlights a dangerous condition, which may be increasing in recent years due to the massive expansion of ECP popularity and a growing number of competitions. Future research should investigate the causes of rhabdomyolysis that occur as a result of ECP, especially training methods and/or tasks developed specifically for these competitions.

Porfiria aguda intermitente com complicações decorrentes do diagnóstico tardio em paciente pediátrico / Acute intermittent porphyria with complications arising from late diagnosis in a pediatric patient

A porfiria é uma doença rara, decorrente da deficiência enzimática associada à biossíntese do grupamento heme. O objetivo deste relato é descrever um caso de crise porfirêmica aguda intermitente em um paciente de 15 anos, que evoluiu rapidamente com tetraplegia e insuficiência renal crônica terminal, além de distúrbios neuropsiquiátricos. Representa uma entidade de difícil diagnóstico devido à inespecificidade dos achados clínicos. À admissão a creatinina era de 6,44 mg/dL e a uréia de 103 mg/dL. Déficit neurológico importante e insuficiência renal crônica são complicações raras, decorrentes do diagnóstico e tratamento tardio. É fundamental que o tratamento seja iniciado imediatamente após o diagnóstico, devido não somente à morbidade a curto-médio prazo, mas também aos possíveis efeitos deletérios permanentes. (AU)

Porphyria is a rare disease, consequence of enzymatic deficiencies associated with heme group biosynthesis. The aim of this report is to describe a case of acute intermittent porphyria crisis in a 15-year-old patient who progressed rapidly with tetraplegia and chronic terminal renal failure, as well as severe neuropsychiatric disorders. It represents an entity of difficult diagnosis due to the lack of specificity of the clinical findings. At admission, creatinine was 6.44 mg / dL and urea was 103 mg / dL. Significant neurological deficit and chronic renal failure are rare complications, arising from late diagnosis and treatment. A greater degree of clinical suspicion is fundamental that treatment be started immediately after diagnosis, due not only to short-term morbidity but also to possible deleterious permanent effects (AU)

Intra-arterial thrombectomy in the management of acute ischemic stroke: evidentiary analysis over the past two years

Stroke is one of the main causes of death and disability worldwide, and the ischemic modality is responsible for the majority of these events. Despite its high occurrence and potentially unfavorable prognosis, the management options were scarce and barely effective until recent times, when a relatively new endovascular intervention with demonstrated superior efficacy as compared with that of classic management was reported in the medical literature. The theoretical basis of this study was conducted through research in virtual databases Public MEDLINE (PubMed) and Scientific Electronic Library Online (SciELO) using associations among the keywords "acute ischemic stroke", "ischemic stroke", "thrombectomy", "endovascular," and "intra-arterial thrombectomy". Clinical trials, meta-analysis, and pertinent literature reviews published in the last two years were reviewed and 14 articles were selected for complete and critical evaluations. The results of the randomized clinical trials, consequences of implantation of the intra-arterial thrombectomy as routine management for eligible groups, cost-effectiveness, and the most related complications and outcomes associated with the procedure are critically explored throughout this study (AU)