Injury incidence and characteristics in adolescent female football players: A systematic review with meta-analysis of prospective studies.

To observe overall, training, and match injury incidence in female youth football. We also aimed to quantify the incidence of injuries by affected tissue and body location. The following databases were examined: PubMed, Web of Science, Scopus, SPORTDiscus, Cochrane and PEDro. Papers that reported overall injury incidence, training or match injury incidence were included. Additionally, studies had to be performed in adolescent female football players (13-19 years of age). The Newcastle-Ottawa Scale and the checklist of items that must be included in epidemiological football reports were used to assess methodological quality of the included articles. For the meta-analyses, a random effect model was used. A total of 13 studies were included. There were 2,333 injuries; incidence was higher during games (12.7/1000 h) compared to training sessions (2.3/1000 h). The injury match-to-training ratio was 5.8. The lower limbs were the region in which the greatest number of injuries occurred, with the ankle (1.2/1000 h) and knee (0.8/1000 h) having the most injuries. In relation to injured tissue, ligament injuries represented an incidence of 1.3/1000 h, followed by muscle injuries (0.9/1000 h). This study represents the first step towards the creation and implementation of preventative measures in female youth football. The results suggest that attention should be focused on ankle and knee injuries, since they are the most frequent and can lead to sport retirement in some cases depending on the severity.

Ethnicity-Based Variations in Focal Adhesion Kinase Signaling in Glioblastoma Gene Expression: A Study of the Puerto Rican Hispanic Population.

Glioblastoma (GBM), an aggressive form of brain cancer, has a higher incidence in non-Hispanics when compared to the US Hispanic population. Using data from RT-PCR analysis of 21 GBM tissue from Hispanic patients in Puerto Rico, we identified significant correlations in the gene expression of focal adhesion kinase and proline-rich tyrosine kinase (PTK2 and PTK2B) with NGFR (nerve growth factor receptor), PDGFRB (platelet-derived growth factor receptor B), EGFR (epithelial growth factor receptor), and CXCR1 (C-X-C motif chemokine receptor 1). This study further explores these correlations found in gene expression while accounting for sex and ethnicity. Statistically significant (p < 0.05) correlations with an r value > ±0.7 were subsequently contrasted with mRNA expression data acquired from cBioPortal for 323 GBM specimens. Significant correlations in Puerto Rican male patients were found between PTK2 and PTK2B, NGFR, PDGFRB, EGFR, and CXCR1, which did not arise in non-Hispanic male patient data. The data for Puerto Rican female patients showed correlations in PTK2 with PTK2B, NGFR, PDGFRB, and EGFR, all of which did not appear in the data for non-Hispanic female patients. The data acquired from cBioPortal for non-Puerto Rican Hispanic patients supported the correlations found in the Puerto Rican population for both sexes. Our findings reveal distinct correlations in gene expression patterns, particularly involving PTK2, PTK2B, NGFR, PDGFRB, and EGFR among Puerto Rican Hispanic patients when compared to non-Hispanic counterparts.

The effect of match congestion on hip adductor squeeze strength in youth rink hockey players

Introduction Groin injuries are common among rink hockey players. Monitoring the main risk factors can reduce the likelihood of suffering such injury. The objective of this study was to evaluate the effect of a competitive congestion period on the squeeze strength of the hip adductor muscles in a group of adolescent rink hockey players, and whether the strength reduction exceeded the injury risk threshold (>15%) for sustaining a groin injury. Materials and Methods Twenty U-16 athletes (9 females) participated in the study. Eighty-three adductor strength measurements were recorded after 10 games (2109 min of play). Function was assessed using the Sport subscale of the Hip and Groin Outcome Score (HAGOS) questionnaire. A simple linear regression model was used to analyze the accumulated time-strength relationship, and the pre-tournament and post-tournament HAGOS results were compared. Results The accumulation of games resulted in a significant strength reduction in male players' (R2= 0.27), but not in females. Eighty-five percent of the sample had their strength reduced to values at risk compared to baseline strength, but none of them stopped their activity due to discomfort in the groin region. HAGOS results were not affected by the competitive congestion (p = 0.07–0.48). Conclusion Match congestion can negatively impact adductor strength. However, there may not be a relationship between strength loss above 15% and the appearance of a groin injury. (AU)

Epidemiology of injuries in elite female rink hockey players: A two season observational study.

OBJECTIVES: To record the time-loss injuries of female rink hockey players and describe the affected region, tissue, and onset of injury. DESIGN: Cross-sectional survey study. SETTING: First (Ok Liga) and Second (Plata) division clubs. PARTICIPANTS: 280 player-seasons. MAIN OUTCOME MEASURES: Incidence of overall, training, and match injuries (number of injuries per 1000 h) from two seasons. RESULTS: A total of 229 injuries occurred in 56,438 h of exposure. The overall incidence was 4 injuries per 1000 h (4/1000 h), with a significantly higher rate of injuries during matches (15.2/1000 h) compared to training sessions (2.6/1000 h) (p < 0.001). Injuries affecting the lower limb were the most common (2.3/1000 h), followed by upper limb (1.2/1000 h), and head/trunk (0.6/1000 h). The tissue with the highest incidence of injury was the muscle/tendon (1.3/1000 h), followed by the ligament (0.8/1000 h). Around one in every three injuries (31%) affected either the thigh or hip/groin (73 injuries). CONCLUSIONS: The injury incidence in elite female rink hockey is moderate and occurs mainly during match sessions. Preventative measurements should be implemented in rink hockey with a special concern for injuries affecting the thigh, and hip/groin.

Intramedullary Spinal Cord Tumors: Whole-Genome Sequencing to Assist Management and Prognosis.

Intramedullary spinal cord tumors (IMSCTs) harbor unique genetic mutations which may play a role in prognostication and management. To this end, we present the largest cohort of IMSCTs with genetic characterization in the literature from our multi-site institutional registry. A total of 93 IMSCT patient records were reviewed from the years 1999 to 2020. Out of these, 61 complied with all inclusion criteria, 14 of these patients had undergone genetic studies with 8 undergoing whole-genomic sequencing. Univariate analyses were used to assess any factors associated with progression-free survival (PFS) using the Cox proportional hazards model. Firth's penalized likelihood approach was used to account for the low event rates. Fisher's exact test was performed to compare whole-genome analyses and specific gene mutations with progression. PFS (months) was given as a hazard ratio. Only the absence of copy neutral loss of heterozygosity (LOH) was shown to be significant (0.05, p = 0.008). Additionally, higher risk of recurrence/progression was associated with LOH (p = 0.0179). Our results suggest LOH as a genetic predictor of shorter progression-free survival, particularly within ependymoma and glioblastoma tumor types. Further genomic research with larger multi-institutional datasets should focus on these mutations as possible prognostic factors.

Isokinetic thigh muscles strength in semi-professional athletics: A one season prospective cohort study

Introduction: Continuous evaluations of athletes, including strength testing, can help control performance improvement or facilitate the restoration of normality after an injury. The aim of the present study was to prospectively determine the peak torque (PT), angle at which PT is achieved, and functional ratios of flexors and extensors thigh muscles during one season. Material and methods Thirty semi-professional male athletes competing in long jumping (n = 10), javelin throwing (n = 10), and sprinting (n = 10) participated. PT was evaluated in relation to limb length; the angle at which PT was achieved was obtained from the force-curve displayed in the isokinetic dynamometer; functional ratios were calculated by dividing concentric hamstring strength by eccentric quadriceps strength (flexor ratio) or vice-versa for the extensor ratio. Assessment was performed at 60º/s and 300º/s. Results Significant variations were seen for both extensor and flexor PTs at different stages of the season, with moderate to large effect sizes observed (effect size (d) = 0.49–0.93). Functional ratios and the angle at which peak torque was achieved remained stable throughout the season. Conclusions Thigh muscle strength is unstable throughout a track and field season, coaches or medical staff should consider these findings when programming training sessions or rehabilitating an athlete. (AU)

Funcionalidad y fuerza de aductores en jugadores de hockey sobrepatines de alto nivel / Adductor functionality and strength in high-level rink hockey players

Objetivo: Evaluar la fuerza de los músculos aductores y la funcionalidad en jugadores de hockey sobre patines de alto nively su relación con sufrir dolor inguinal (DI) en la temporada anterior. Material y método: Se realizó un estudio transversal donde se registraron los valores de fuerza mediante el Squeeze Test de5 segundos (5SST), y la funcionalidad de la cadera e ingle mediante el cuestionario Hip and Groin Outcome Score (HAGOS) enuna población de 11 jugadores de hockey sobre patines de alto nivel. Resultados: La prevalencia total de DI fue de 81,8% (en la anterior temporada el 54% sufrió DI), de los cuales un 18,2% llegóa detener la práctica deportiva. La fuerza media para el 5SST es de 254,68N (3,25Nm/kg) y la funcionalidad alcanzó los 90/100puntos en el cuestionario HAGOS para toda la muestra. La fuerza muscular fue similar entre jugadores que habían sufridoDI con pérdida de tiempo durante la última temporada y jugadores sanos en (p =0,261-0,948; g: 0,04-0,85). Se encontrarondiferencias significativas en las siguientes subescalas del cuestionario HAGOS: Dolor, actividades deportivas y recreacionales,y calidad de vida entre ambos grupos (p =0,005-0,042; g: 0,34-2,65; r: 0,3-0,61). Conclusión: Más de la mitad de los jugadores sufrieron DI, de los cuales un tercio llegó a detener su actividad. La funcionalidadmedida a través del HAGOS se erige como el principal indicador que mostró diferencias entre grupos. Los servicios médicosde jugadores jóvenes de hockey sobre patines deberían usar este cuestionario para poder detectar precozmente la aparicióny evitar la progresión de esta lesión.(AU)

Objective: To evaluate adductor strength and groin function in high level rink hockey players and its relationship with groinpain in the previous season. Material and method: A cross-sectional study was performed where hip/groin strength and function was assessed via 5seconds Squeeze Test and Hip and Groin Ouctome Score in 11 high level rink hockey players. Results: Overall prevalence for groin pain was 81.8% (54% of the participants suffered groin pain during the previous season),and 18.2% suffered time-loss groin pain. Mean strength in the 5SST was 254.68N (3.25Nm/Kg) and HAGOS questionnairereached 90/100 points in the whole sample. Similar adductor strength values were observed between healthy athletes andpreviously injured who suffered time-loss groin pain (P=0.261-0.948; g: 0.04-0.85). Statistically significant differences werefound for the following HAGOS subscales: Pain, function, sports and recreational activities, and quality of life between groups(P=0.005-0.042; g: 0.34-2.65; r: 0.3-0.61). Conclusion: More than a half of the participants suffered groin pain, of which one third suffered time-loss groin pain. Functionassessed via HAGOS seems to be the main proxy that discriminates between groups. Medical staff should implement thisquestionnaire to detect and avoid the progression of this injury.(AU)

Tumor filodes bilateral, una rara forma de manifestación clínica: reporte de caso / Bilateral phyllodes tumor, a rare form of clinical presentation: A case report

Resumen ANTECEDENTES: La incidencia de tumores filodes es del 0.3 al 1% de todos los tumores primarios de la mama. Su presentación bilateral puede ser sincrónica o asincrónica y es excepcional. Estos tumores se clasifican (OMS) en fibroepiteliales, benignos, limítrofes o malignos. Aparecen en mujeres con límites muy amplios de edad, aunque lo más frecuente es entre los 35 y 55 años. El diagnóstico definitivo se establece con base en el reporte histopatológico. Su tratamiento es quirúrgico. CASO CLÍNICO: Paciente de 50 años, con antecedentes obstétricos de dos embarazos y dos cesáreas. Acudió a consulta debido a la aparición de una masa palpable en ambas mamas. Carecía de antecedentes relevantes para cáncer de mama. Con base en la mastografía se determinó que se trataba de un tumor categoría BI-RADS 4A. La biopsia excisional, con estudio transoperatorio, determinó que era un tumor filodes de bajo grado (benigno). Se procedió a la extirpación de ambos tumores, con márgenes libres suficientes, a fin de disminuir el riesgo de recidivas. Se determinó un plan de seguimiento con mastografía anual en las que se ha obtenido la categoría BI-RADS 2. Hasta el momento, la paciente permanece libre de enfermedad. CONCLUSIONES: Los tumores filodes son sumamente raros y más aún su aparición bilateral. Es importante integrar un diagnóstico temprano y efectuar un correcto procedimiento quirúrgico que evite las recidivas porque éstas tienden a ser cada vez más agresivas. Sigue siendo motivo de controversia la indicación de radioterapia y quimioterapia en estos tumores, que solo se reservan como tratamiento alternativo ante tumores sumamente agresivos.

Abstract BACKGROUND: The incidence of phyllodes tumors is 0.3% to 1% of all primary breast tumors. Their bilateral presentation may be synchronous or asynchronous and is exceptional. These tumors are classified (WHO) as fibroepithelial, benign, borderline or malignant. They appear in women with very wide age limits, although the most frequent is between 35 and 55 years of age. The definitive diagnosis is established based on the histopathological report. Treatment is surgical. CLINICAL CASE: 50-year-old patient with obstetric history of two pregnancies and two cesarean sections. She came for consultation due to the appearance of a palpable mass in both breasts. She had no relevant history of breast cancer. Based on the mastography it was determined to be a BI-RADS 4A category tumor. The excisional biopsy, with trans-operative study, determined that it was a low-grade (benign) phyllodes tumor. Both tumors were excised, with sufficient free margins, in order to reduce the risk of recurrence. A follow-up plan was determined with annual mastography in which BI-RADS category 2 has been obtained. So far, the patient remains free of disease. CONCLUSIONS: Phyllodes tumors are extremely rare and even more so their bilateral occurrence. It is important to integrate an early diagnosis and to perform a correct surgical procedure to avoid recurrences because they tend to be more and more aggressive. The indication of radiotherapy and chemotherapy in these tumors remains controversial and is only reserved as an alternative treatment for highly aggressive tumors.

Guía de Práctica Clínica de cuerpo extraño gastrointestinal en niños / Clinical practice guideline of gastrointestinal foreign bodies in children

La ingestión de un cuerpo extraño es un tipo de lesión no intencionada muy frecuente en la infancia, particularmente en lactantes mayores de 6 meses y preescolares. El propósito deseado con la publicación de esta guía es contar con herramientas actualizadas en el diagnóstico y tratamiento de esta afección que permitan sistematizar la conducta y mejorar la calidad de la asistencia médica. Dentro de los cuerpos extraños más frecuentes tenemos: monedas, imanes, baterías, juguetes pequeños, plásticos, joyas, botones, huesos e impactaciones alimentarias en los niños mayores. La sintomatología varía según la naturaleza del cuerpo extraño, el lugar donde se impacte, que casi siempre es en las estrecheces anatómicas o adquiridas del tubo digestivo o por la presencia de complicaciones. Para confirmar el diagnóstico son necesarios diferentes estudios imagenológicos y endoscópicos, estos últimos con un valor terapéutico. El tratamiento depende de factores como la edad, el tiempo de ingerido, la localización, la presencia de complicaciones, la naturaleza del cuerpo extraño, su número y el potencial lacerante, tóxico o corrosivo. En la mayoría de los casos los cuerpos extraños son expulsados de forma espontánea y tienen un pronóstico favorable, pero queda un grupo de pacientes donde es necesario un tratamiento quirúrgico. Después de realizar una búsqueda de revisiones sistemáticas de calidad y tomando en cuenta la experiencia del Servicio de Cirugía Pediátrica de Matanzas en el tratamiento de estos pacientes se elaboró esta guía que fue discutida y aprobada en el IV Simposio Nacional de Cirugía Pediátrica. La publicación de esta guía permitiría a los servicios de Cirugía Pediátrica emplearla como referencia y aplicarla en sus propias instituciones con el consecuente beneficio para los pacientes(AU)

Ingestion of a foreign body is a very common type of unintentional injury in childhood, particularly in infants older than 6 months and preschoolers. The desired purpose with the publication of this guideline is to have up-to-date tools in the diagnosis and treatment of this condition that allow to systematize the behavior and improve the quality of medical care. Within the most frequent foreign bodies we have: coins, magnets, batteries, small toys, plastics, jewelry, buttons, bones and food impactations in older children. Symptomatology varies depending on the nature of the foreign body, the place where it impacted, which is almost always in anatomical or acquired narrowness of the digestive tract, or by the presence of complications. To confirm the diagnosis, different imaging and endoscopic studies are necessary, the latter with a therapeutic value. Treatment depends on factors such as age, ingestion time, location, presence of complications, the nature of the foreign body, the amount and the lacerating, toxic or corrosive potential. In most cases foreign bodies are expelled spontaneously and have a favorable prognosis, but there is a group of patients left for whom surgical treatment is necessary. After conducting a search for quality systematic reviews and taking into account the experience of Matanzas province's Pediatric Surgery Service in the treatment of these patients, this guideline was created and it was discussed and approved at the IV National Symposium of Pediatric Surgery. The publication of this guideline would allow Pediatric Surgery services to use it as a reference and apply it in their own institutions with the consequent benefit for patients(AU)

COVID-19: A look to the future / COVID-19: una mirada al futuro

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Comparison of intensity and post-effort response in three interval trainings in young tennis players: running interval, specificinterval, and specific intermittent training / Comparación de la intensidad y la respuesta post-esfuerzo en tres entrenamientos interválicos en jóvenes tenistas: interválico de carrera, interválico específico e intermitente específico

INTRODUCTION: In recent years, considerable interest has been shown in adapting training to the specific characteristics of tennis. The use of intermittent exercise seems to adapt better to the sport's work/recovery structure and using specific movements allows for local adaptations and complex work. Nevertheless, we need to achieve a level of intensity that is at least similar to what is achieved when continuous running is used. The ability to recover between points is also a decisive factor in terms of performance. Our hypothesis is that recovery depends on stimulus type, which means the most suitable stimuli must be chosen to improve this capacity. MATERIAL AND METHOD: Our study's goal was to compare the intensity and post-effort behaviour triggered by three types of exercise: continuous running with 2-minute intervals (GIT ), rallies with 2-minute intervals (SIT ) and intermittent rallies (SIIT ). We measured heart rate (HR) and blood lactate levels during the three exercises, as well as the recovery to 130 beats and in the first 10 and 20 seconds post-effort. RESULTS: Heart rate intensity was significantly higher in SIT than in GIT and lactate levels were higher in both SIT and SIIT compared to GIT. Heart rate recovery is significantly slower in both specific exercises, increasing in the first 10 and 20 seconds with SIIT. DISCUSSION: We have reached the conclusion that specific training led to greater intensity in the specific exercises. Post-effort response is slower in the specific trainings and paradoxical in the initial seconds of intermittent training

INTRODUCCIÓN: En los últimos años se ha producido un gran interés por adaptar el entrenamiento a la especificidad del tenis. El uso de ejercicios intermitentes parece adaptarse más a la estructura de trabajo/recuperación de este deporte que las actividades continuas. A su vez, utilizar movimientos específicos permite adaptaciones locales y trabajar de forma compleja. Sin embargo, se necesita alcanzar un nivel de intensidad que sea al menos similar al que se logra cuando se utiliza la carrera continua. La capacidad de recuperar entre puntos es un factor decisivo en el rendimiento. Nuestra hipótesis es que la recuperación puede ser diferente según sea el tipo de estímulo y que habrá que escoger los más adecuados para mejorar esta capacidad. No obstante, es necesario que estos entrenamientos tengan una intensidad al menos similar a cuando se utiliza la carrera continua. MATERIAL Y MÉTODO: Nuestro objetivo en este estudio es comparar la intensidad y el comportamiento post-esfuerzo de tres ejercicios: carrera continua con intervalos de 2 minutos (GIT ), golpeo de bolas con intervalos de 2 minutos (SIT ), golpeo de bolas con intermitencias (SIIT ). Hemos medido la HR y el lactato durante los tres ejercicios y la recuperación a 130 pulsaciones, y en los 10 y 20 segundos post-esfuerzo. RESULTADOS: La intensidad cardiaca fue significativamente mayor en SIT que en GIT, y el lactato superior en SIT y SIIT, respecto a GIT. La recuperación cardiaca es significativamente más lenta en ambos ejercicios específicos, llegando a incrementarse en los 10 y 20 segundos iníciales en SIIT. DISCUSIÓN: Concluimos que con el entrenamiento específico se ha alcanzado una elevada intensidad en los trabajos específicos. La respuesta post-esfuerzo es más lenta en los entrenamientos específicos, y paradójica en los primeros segundos en el entrenamiento intermitente

Aspectos éticos de la toma y el uso de la fotografía en la práctica pediátrica / Ethical aspects of taking and using photographs in pediatric medical practice

Desde los inicios de la medicina, la reproducción de imágenes de pacientes, ya sea con fines didácticos o de compartir experiencias, fue considerada una práctica habitual en el quehacer médico. La aparición de la fotografía facilitó y generalizó enormemente esta práctica dentro de los equipos de salud. Las imágenes de los pacientes requieren el mismo consentimiento y garantías de confidencialidad que otras partes del registro médico. Se remarca la importancia del consentimiento informado. Se considera la responsabilidad legal de estos actos.

From the beginning of medicine, the reproduction of patients' images, initially as drawings, either for didactic purposes or to share experiences, were common in medical practice. Photography greatly facilitated and generalized this practice within health teams. The images of the affected patients need the same consents and guarantees of confidentiality as any other parts of the medical record, so the importance of obtaining informed consent is highlighted. Beyond ethical aspects, professionals have to take into account the legal responsibility involved in carrying out this act.

Escala de Borg e intensidad en entrenamientos de carrera y específicos de tenis / Borg Scale and Intensity in Running and Specific Tennis Training

Se determinaron las diferencias en la intensidad y la valoración subjetiva de la fatiga en entrenamientos de carrera continua y específicos de tenis. Trece tenistas varones jóvenes tomaron parte en tres entrenamientos de resistencia de tipo continuo de 14 minutos de duración. Uno general consistente en carrera continua (CC), otro específico de peloteo cruzado (EP), y por último uno específico competitivo mediante puntos (EC). Fue registrada la frecuencia cardiaca; y se valoró, al finalizar las tres pruebas, el lactato y la percepción de la fatiga. Se registraron valores más altos de frecuencia cardiaca y lactato en los dos ejercicios específicos, siendo significativamente superiores en EC respecto a CC (Frecuencia cardiaca p>0.0054. Lactato p>0.0320). Sin embargo, en la Escala de Borg no hubo diferencias significativas. Este estudio sugiere, para este grupo, que los valores de la Escala de Borg en ejercicios específicos de tenis pueden infravalorar la intensidad en relación con los de carrera

Differences in intensity and subjective valuation of fatigue in continous running trainings and specific tennis exercises were determined. Thirteen young mal tennis players took part in three continuous type endurance training with 14 minutes length. A general one consisting of continuous running (CC) a specific one of a cross-knock up (EP) and finally a competitive specific one by points (EC). The heart rate was recorded and the lactate and perception of fatigue were evaluated at the end of the three tests. Higher heart rate and lactate values were recorded in the two specific exercises being significantly higher in EC regardin to CC (Heart rate p>0.0054. Lactate p>0.0320). However, there were no significant differences in the Borg Scale. This study suggest that the values of the Borg Scale in specific tennis exercises may undervalue the intensity in relation to the running values

El entrenamiento intermitente específico de alta intensidad en la preparación del jugador de tenis / High-intensity specific intermittent training (SIT) in the preparation of the tennis player

La capacidad de realizar acciones a alta velocidad de forma repetida tiene una relación muy clara con la manifestación de la resistencia en deportes como el tenis. El entrenamiento en el que se intercalan periodos de trabajo de alta intensidad con otros de recuperación resulta un tipo de entrenamiento más específico que el de tipo continuo. Dentro de los sistemas interválicos, los entrenamientos intermitentes de alta intensidad (Intermittent Training-IT) suponen un método especialmente adecuado para mejorar la resistencia aeróbica y anaeróbica. Mediante este entrenamiento se podrá actuar sobre las adaptaciones relacionadas con la recuperación entre puntos, lo que tiene una relación directa con el rendimiento en los partidos. Además, la alta intensidad y el bajo volumen de entrenamiento permite una óptima sinergia con cualidades como la fuerza explosiva y la velocidad, tan importantes en deportes en los que se intercalan periodos de trabajo y recuperación. Sin embargo, el tenis tiene unas características específicas que lo diferencian de otros deportes intermitentes, como son las recuperaciones breves, y la técnica de desplazamiento y de golpeo de la pelota, por lo que la utilización del entrenamiento intermitente usando movimientos propios del tenis (Specific Intermittent Training-SIT), es un sistema especialmente adecuado. La elección de la intensidad del esfuerzo, de la relación entre tiempos de trabajo y recuperación y el grado de destreza del jugador, son factores determinantes a la hora de realizar entrenamientos específicos a alta intensidad. En esta revisión se intenta mostrar el interés del entrenamiento SIT como herramienta básica para potenciar las mejoras de los diferentes factores del rendimiento en tenistas

The ability to perform actions repeatedly at high speed has a very clear relationship with the manifestation of endurance in sports such as tennis. The training in which there are interspersed periods of work of high intensity with others of recovery turns out to be a type of training more specific than continuous type. Within the interval systems, the intermittent training of high intensity (Intermittent training-IT) suppose a specially suitable method to improve aerobic and anaerobic endurance. Through this training will we be able to act on the adaptations related to the recovery between points, which has a direct relationship with the performance in the matches. In addition, the high intensity and low volume of training allows an optimal synergy with qualities such as explosive force and speed, so important in sports in which periods of work and recovery are interspersed. However, tennis has some specific characteristics that differentiate it from other intermittent sports such as brief recoveries and techniques of displacement and hitting the ball, so the use of intermittent training using typical movements of tennis (Specific Intermittent Training-SIT) is an especially suitable system. The choice of the intensity of the effort of the relationship between work and recovery times, and the degree of skill of the player are determining factors when carrying out specific training at high intensity. In this review we try to show the interest of SIT training as a basic tool to encourage the improvements of the different factors of performance in tennis players

Esplenectomía parcial en niños con anemias hemolíticas congénitas en el Hospital Pediátrico Docente de Matanzas Eliseo Noel Caamaño / Partial splenectomy in children with congenital hemolytic anemia in the Pediatric Hospital Eliseo Noel Caamaño of Matanzas

Introducción: las anemias hemolíticas se caracterizan por una destrucción precoz de los hematíes, con un acortamiento de su vida media. Estos pacientes pueden requerir para el control de la enfermedad o por el desarrollo de complicaciones esplénicas, la necesidad de ser sometidos a una esplenectomía. Por la morbilidad y posibles complicaciones letales como la sepsis post-esplenectomía de la esplenectomía total en niños, se ha empleado la esplenectomía parcial como opción de tratamiento quirúrgico. Objetivo: evaluar los resultados de la esplenectomía parcial en los pacientes con anemias hemolíticas congénitas. Materiales y Métodos: se realizó un estudio prospectivo, descriptivo longitudinal, del universo de los 15 pacientes con anemias hemolíticas congénitas a los que se les realizó esplenectomía parcial. Resultados: se encontró que la drepanocitosis y la esferocitosis hereditaria fueron los diagnósticos más frecuentes dentro de los casos operados. Las principales indicaciones de la esplenectomía parcial fueron la crisis de secuestro esplénico y la necesidad de transfusiones de sangre respectivamente. Las variables hematológicas analizadas en el período postoperatorio mostraron una respuesta favorable al tratamiento quirúrgico. Conclusiones: la esplenectomía parcial llevó a un mejoramiento clínico y hematológico en los pacientes con anemias hemolíticas congénitas, tributarios de tratamiento quirúrgico, sin complicaciones significativas en un período de seguimiento de 5 años (AU).

Introduction: congenital hemolytic anemia are characterized by an early destruction of red blood cells, with a shortening of their average life. For the control of the disease or due to the development of splenic complications, these patients may require to undergo splenectomy. Due to the morbidity and possible lethal complications such as post-splenectomy sepsis of total splenectomy in children, partial splenectomy has been used as a surgical treatment option. Objective: to evaluate the results of partial splenectomy in patients with congenital hemolytic anemia. Materials and Methods: a longitudinal prospective, descriptive study was performed in 15 patients with congenital hemolytic anemia who underwent partial splenectomy. Results: sickle cell disease and hereditary spherocytosis were the most frequent diagnoses in the group of operated cases. The main indications of partial splenectomy were splenic sequester crises and the necessity of blood transfusions respectively. The hematologic variables analyzed in the post-surgery period showed a favorable answer to surgical treatment. Conclusions: partial splenectomy led to a hematologic and clinical improvement in patients with congenital hemolytic anemia, tributary of surgical treatment, without significant complications in a 5-year follow-up period (AU).

Esplenectomía parcial en niños con anemias hemolíticas congénitas en el Hospital Pediátrico Docente de Matanzas Eliseo Noel Caamaño / Partial splenectomy in children with congenital hemolytic anemia in the Pediatric Hospital Eliseo Noel Caamaño of Matanzas

Introducción: las anemias hemolíticas se caracterizan por una destrucción precoz de los hematíes, con un acortamiento de su vida media. Estos pacientes pueden requerir para el control de la enfermedad o por el desarrollo de complicaciones esplénicas, la necesidad de ser sometidos a una esplenectomía. Por la morbilidad y posibles complicaciones letales como la sepsis post-esplenectomía de la esplenectomía total en niños, se ha empleado la esplenectomía parcial como opción de tratamiento quirúrgico. Objetivo: evaluar los resultados de la esplenectomía parcial en los pacientes con anemias hemolíticas congénitas. Materiales y Métodos: se realizó un estudio prospectivo, descriptivo longitudinal, del universo de los 15 pacientes con anemias hemolíticas congénitas a los que se les realizó esplenectomía parcial. Resultados: se encontró que la drepanocitosis y la esferocitosis hereditaria fueron los diagnósticos más frecuentes dentro de los casos operados. Las principales indicaciones de la esplenectomía parcial fueron la crisis de secuestro esplénico y la necesidad de transfusiones de sangre respectivamente. Las variables hematológicas analizadas en el período postoperatorio mostraron una respuesta favorable al tratamiento quirúrgico. Conclusiones: la esplenectomía parcial llevó a un mejoramiento clínico y hematológico en los pacientes con anemias hemolíticas congénitas, tributarios de tratamiento quirúrgico, sin complicaciones significativas en un período de seguimiento de 5 años (AU).

Introduction: congenital hemolytic anemia are characterized by an early destruction of red blood cells, with a shortening of their average life. For the control of the disease or due to the development of splenic complications, these patients may require to undergo splenectomy. Due to the morbidity and possible lethal complications such as post-splenectomy sepsis of total splenectomy in children, partial splenectomy has been used as a surgical treatment option. Objective: to evaluate the results of partial splenectomy in patients with congenital hemolytic anemia. Materials and Methods: a longitudinal prospective, descriptive study was performed in 15 patients with congenital hemolytic anemia who underwent partial splenectomy. Results: sickle cell disease and hereditary spherocytosis were the most frequent diagnoses in the group of operated cases. The main indications of partial splenectomy were splenic sequester crises and the necessity of blood transfusions respectively. The hematologic variables analyzed in the post-surgery period showed a favorable answer to surgical treatment. Conclusions: partial splenectomy led to a hematologic and clinical improvement in patients with congenital hemolytic anemia, tributary of surgical treatment, without significant complications in a 5-year follow-up period (AU).

Ruptura traumática de la arteria vertebral por herida penetrante en el cuello / Traumatic rupture of the vertebral artery caused by penetrating neck injury

Introducción: la exanguinación es una entidad clínica dramática que requiere rapidez de pensamiento y acción para obtener buenos resultados.Presentación del caso: se reporta el caso de un paciente de 13 años que sufrió accidente automovilístico y fue atendido en el Hospital Pediátrico "Eliseo Noel Camaño", de la provincia de Matanzas, Cuba. El niño llegó con múltiples traumas en miembros superiores e inferiores, y una herida penetrante en el cuello que requirió tratamiento quirúrgico inmediato para controlar hemorragia. Se necesitó un acceso multidisciplinario de intensivistas, anestesiólogos, cirujanos pediátricos, neurocirujanos y cirujanos vasculares, porque la cuantía del sangrado y la localización de la lesión hicieron sospechar una afección traumática de la arteria vertebral. El niño sobrevivió a la lesión exanguinante, y actualmente se encuentra en proceso de recuperación.Conclusiones: la lesión penetrante del cuello puede provocar ruptura traumática de la arteria vertebral, entidad infrecuente que requiere alta sospecha diagnóstica para lograr éxito en su tratamiento. Consideramos vital la visión multidisciplinaria, en la que deben prevalecer maniobras seguras, rápidas y eficientes(AU)

Introduction: exsanguination is a dramatic clinical condition that requires quick analysis and action to achieve good results.Case report: this is a 13 years/old patient who suffered a car accident and was seen at "Eliseo Noel Camano" pediatric hospital in Matanzas province, Cuba. The teenager had many upper and lower limb traumas and a penetrating neck injury that required immediate surgery to control hemorrhage. It was necessary to involve intensive care experts, anesthesiologists, pediatric surgeons, neurosurgeons, and vascular surgeons because the amount of bleeding and the location of injury aroused the suspicion of traumatic damage of the vertebral artery. The teenager managed to survive from the exsanguinating injury and is currently in his recovery process.Conclusions: the penetrating neck injury may cause traumatic rupture of the vertebral artery, an uncommon condition that requires great diagnostic suspicion in order to succeed in treatment. It is vital to have a multidisciplinary vision in which safe, rapid and effective procedures should prevail(AU)