Primary Vitrectomy versus Tap and Inject for Fungal Endophthalmitis: Meta-Analysis and Comparison with Data from a Reference Centre.

PURPOSE: We aimed to compare the visual outcomes after pars plana vitrectomy (PPV) versus tap and inject (T&I) in fungal endophthalmitis (FE) reported in the literature and to compare the findings from the literature with data from a reference centre. METHODS: We performed a systematic review and meta-analysis of studies reporting the use of PPV versus T&I in FE. We also performed a retrospective review of the clinical records of patients with endophthalmitis from a reference centre in Colombia. RESULTS: We included 13 studies with 334 eyes; 53.59% received PPV and 46.4% received T&I. The overall relative risk of improving ≥ 2 lines in PPV versus T&I was 0.98 (95% confidence interval [CI] 0.80-1.22; p = 0.88) with a mean difference of final visual acuity of 0.26 (95% CI 0.12-0.63; p = 0.18). There were no significant differences in subgroup analysis. Data from the reference centre included 32 endophthalmitis cases, 15.6% of which had a fungal aetiology (80% received PPV and 20% T&I). There were no significant differences in the subgroup analysis. CONCLUSIONS: Based on the findings from the literature and the reference centre, T&I is noninferior to PPV. This is the first meta-analysis in the literature evaluating these effects in FE. It is necessary to execute new prospective randomised controlled studies in patients with endophthalmitis.

Positive Effects of Plyometric vs. Eccentric-Overload Training on Performance in Young Male Handball Players.

This study aimed to compare the effects of two 8-week in-season strength-training programs on handball players' physical and technical parameters. Thirty-six male athletes were randomly separated into three groups: a control group (n = 12), a plyometric training group (PG, n = 12), and an eccentric-overload training group (EG, n = 12). The PG and EG performed upper- and lower-limb plyometric or eccentric-overload exercises, respectively, three times per week. Control groups performed regular handball training. The athletes were assessed for counter movement jump (CMJ) and Abalakov vertical jump (ABK) height, 15 m linear sprint time, handball-throwing speed (i.e., penalty throw; 3-step running throw; jump throw), and cardiorespiratory endurance through the 20 m shuttle-run test. Heart rate and blood lactate were measured at the end of the endurance test. No baseline differences were noted for dependent variables between groups. The session rating of perceived exertion was similar between the intervention groups (PG = 361 ± 12.2 AU; EG = 370 ± 13.3 AU). The ANOVA revealed significant (p < 0.05; Δ = 5-9%; effect size (ES) = 0.45-1.96). Similar improvements for experimental groups compared to the control group for CMJ, ABK jump, penalty throw, 3-step running throw, and jump throw. However, interventions did not affect 15 m, cardiorespiratory endurance, nor heart rate or blood lactate after the endurance test. In conclusion, an 8-week handball intervention by performing plyometric or eccentric-overload training in-season improves the physical and technical parameters of male players when compared to regular handball practice.

ENDOPHTHALMITIS IN OPHTHALMOLOGICAL REFERRAL CENTRE IN COLOMBIA: AETIOLOGY AND MICROBIAL RESISTANCE.

AIMS: To describe the aetiology and microbial susceptibility profile of endophthalmitis cases treated at an ophthalmological referral centre in Colombia. MATERIAL AND METHODS: A retrospective descriptive study was carried out with all endophthalmitis cases referred to the Fundación Oftalmológica de Santander FOSCAL (Floridablanca, Colombia) from 1 January 2012 to 31 December 2015. RESULTS: 121 eyes of 121 patients were evaluated. 77.7% of them were male and the mean age was 42.9 years. Five of them (4.1%) corresponded to endogenous endophthalmitis, and 116 (95.9%) to exogenous endophthalmitis. Of the latter, 66.9% were associated with trauma (almost one-half of them associated with intraocular foreign body), and 29.5% with intraocular surgery. The most common isolated microorganisms in the exogenous endophthalmitis group corresponded to methicillin-resistant and methicillin-sensitive strains of Staphylococcus epidermidis and Staphylococcus aureus, which were mostly susceptible to imipenem, vancomycin and moxifloxacin and resistant to ceftazidime. CONCLUSION: Endophthalmitis is a potentially sight-threatening condition, especially in cases of inadequate treatment. Therefore, antimicrobial therapy should be guided by vitreous humour culture to assure that the causative microorganism is susceptible to the selected agent. The results of our study lead us to propose vancomycin, moxifloxacin or imipenem as first-line antimicrobial options.

Optimal sampling frequency in recording of resistance training exercises.

The purpose of this study was to analyse the raw lifting speed collected during four different resistance training exercises to assess the optimal sampling frequency. Eight physically active participants performed sets of Squat Jumps, Countermovement Jumps, Squats and Bench Presses at a maximal lifting speed. A linear encoder was used to measure the instantaneous speed at a 200 Hz sampling rate. Subsequently, the power spectrum of the signal was computed by evaluating its Discrete Fourier Transform. The sampling frequency needed to reconstruct the signals with an error of less than 0.1% was f99.9 = 11.615 ± 2.680 Hz for the exercise exhibiting the largest bandwidth, with the absolute highest individual value being 17.467 Hz. There was no difference between sets in any of the exercises. Using the closest integer sampling frequency value (25 Hz) yielded a reconstruction of the signal up to 99.975 ± 0.025% of its total in the worst case. In conclusion, a sampling rate of 25 Hz or above is more than adequate to record raw speed data and compute power during resistance training exercises, even under the most extreme circumstances during explosive exercises. Higher sampling frequencies provide no increase in the recording precision and may instead have adverse effects on the overall data quality.

Repeated-High-Intensity-Running Activity and Internal Training Load of Elite Rugby Sevens Players During International Matches: A Comparison Between Halves.

PURPOSE: To describe the repeated-high-intensity activity and internal training load of rugby sevens players during international matches and to compare the differences between the 1st and 2nd halves. METHODS: Twelve international-level male rugby sevens players were monitored during international competitive matches (n = 30 match files) using global positioning system technology and heart-rate monitoring. RESULTS: The relative total distance covered by the players throughout the match was 112.1 ± 8.4 m/ min. As a percentage of total distance, 35.0% (39.2 ± 9.0 m/min) was covered at medium speed and 17.1% (19.2 ± 6.8 m/min) at high speed. A substantial decrease in the distance covered at >14.0 km/h and >18.0 km/h, the number of accelerations of >2.78 m/s and >4.0 m/s, repeated-sprint sequences interspersed with ≤60 s rest, and repeated-acceleration sequences interspersed with ≤30 s or ≤60 s rest was observed in the 2nd half compared with the 1st half. A substantial increase in the mean heart rate (HR), HRmax, percentage of time at >80% HRmax and at >90% HRmax, and Edwards training load was observed in the 2nd half compared with the 1st half. CONCLUSION: This study provides evidence of a pronounced reduction in high-intensity and repeated-high-intensity activities and increases in internal training load in rugby sevens players during the 2nd half of international matches.

Acceleration capability in elite sprinters and ground impulse: Push more, brake less?

Overground sprint studies have shown the importance of net horizontal ground reaction force impulse (IMPH) for acceleration performance, but only investigated one or two steps over the acceleration phase, and not in elite sprinters. The main aim of this study was to distinguish between propulsive (IMPH+) and braking (IMPH-) components of the IMPH and seek whether, for an expected higher IMPH, faster elite sprinters produce greater IMPH+, smaller IMPH-, or both. Nine high-level sprinters (100-m best times range: 9.95-10.60s) performed 7 sprints (2×10 m, 2×15 m, 20 m, 30 m and 40 m) during which ground reaction force was measured by a 6.60 m force platform system. By placing the starting-blocks further from the force plates at each trial, and pooling the data, we could assess the mechanics of an entire "virtual" 40-m acceleration. IMPH and IMPH+ were significantly correlated with 40-m mean speed (r=0.868 and 0.802, respectively; P<0.01), whereas vertical impulse and IMPH- were not. Multiple regression analyses confirmed the significantly higher importance of IMPH+ for sprint acceleration performance. Similar results were obtained when considering these mechanical data averaged over the first half of the sprint, but not over the second half. In conclusion, faster sprinters were those who produced the highest amounts of horizontal net impulse per unit body mass, and those who "pushed more" (higher IMPH+), but not necessarily those who also "braked less" (lower IMPH-) in the horizontal direction.

Match-play activity profile in elite women's rugby union players.

The aim of this study was to provide an objective description of the locomotive activities and exercise intensity undergone during the course of an international-level match of female rugby union. Eight players were analyzed using global positioning system tracking technology. The total distance covered by the players during the whole match was 5,820 ± 512 m. The backs covered significantly more distance than the forwards (6,356 ± 144 vs. 5,498 ± 412 m, respectively). Over this distance, 42.7% (2,487 ± 391 m) was spent standing or walking, 35% jogging (2,037 ± 315 m), 9.7% running at low intensity (566 ± 115 m), 9.5% at medium intensity (553 ± 190 m), 1.8% at high intensity (105 ± 74 m), and 1.2% sprinting (73 ± 107 m). There were significant differences in the distance covered by forwards and backs in certain speed zones. Analysis of the relative distance traveled over successive 10-minute period of match play revealed that the greatest distances were covered during the first (725 ± 53 m) and the last (702 ± 79 m) 10-minute period of the match. The average number of sprints, the average maximum distance of sprinting, the average minimum distance of sprinting, and the average sprint distance during the game were 4.7 ± 3.9 sprints, 20.6 ± 10.5 m, 5.8 ± 0.9 -m, and 12.0 ± 3.8 m, respectively. There were substantial differences between forwards and backs. Backs covered greater total distance, distance in certain speed zones, and sprinting performance. The players spent 46.9 ± 28.9% of match time between 91 and 100% of maximum heart rate and experienced a large number of impacts (accelerometer data and expressed as g forces) during the game. These findings offer important information to design better training strategies and physical fitness testing adapted to the specific demands of female rugby union.

Force variability during isometric wrist flexion in highly skilled and sedentary individuals.

The association of expertness in specific motor activities with a higher ability to sustain a constant application of force, regardless of muscle length, has been hypothesized. Ten highly skilled (HS group) young tennis and handball athletes and 10 sedentary (S group) individuals performed maximal and submaximal (5, 10, 20, 50, and 75% of the MVC) isometric wrist flexions on an isokinetic dynamometer (Kin-Com, Chattanooga). The wrist joint was fixed at five different angles (230, 210, 180, 150, and 1300). For each position the percentages of the maximal isometric force were calculated and participants were asked to maintain the respective force level for 5 s. Electromyographic (EMG) activation of the Flexor Carpi Ulnaris and Extensor Digitorum muscles was recorded using bipolar surface electrodes. No significant differences were observed in maximal isometric strength between HS and S groups. Participants of HS group showed significantly (P < 0.05) smaller force coefficient of variability (CV) and SD values at all submaximal levels of MVC at all wrist angles. The CV and SD values remained unaltered regardless of wrist angle. No difference in normalized agonist and antagonist EMG activity was observed between the two groups. It is concluded that long-term practice could be associated with decreased isometric force variability independently from muscular length and coactivation of the antagonist muscles.

Functional performance, maximal strength, and power characteristics in isometric and dynamic actions of lower extremities in soccer players.

The purposes of the present study were to determine muscle strength and power output characteristics in a group of professional soccer players and to identify their relationships with 2 functional performance tests (vertical jumping height and 15-m sprint time). Maximal strength and power indices attained against different loads in barbell back squat exercise, isometric maximal force of the knee extensor and plantar flexor muscles, isokinetic peak torque of the knee extensors muscles, vertical jumping height in squat and counter-movement jumps, and 15-m sprint time tests were assessed in 21 semiprofessional soccer players (age 20 +/- 3.8 years). Correlation analyses were performed to examine the relationship between each of these measures. The main results of the present study were that (a) maximal power in concentric half-squat exercise was attained with a load of 60% of 1 repetition maximum, representing 112% of body weight; (b) the performance in the functional tests selected was significantly related with all the half-squat variables measured, especially with loads of 75-125% of body weight; and (c) low to nonsignificant correlations were found between functional tests performance and isometric and isokinetic muscle strength measures. It was concluded that in semiprofessional soccer players (a) isometric and isokinetic muscle strength assessed in an open kinetic chain were not movement-specific enough to predict performance during a more complex movement, such as jump or sprint and (b) concentric half-squat exercise was principally related with the functional tests selected when it was performed against external loading within the range of the load in case of which the maximal power output was attained.