Quality of life and outcomes after rubber band ligation for haemorrhoidal disease.

PURPOSE: The main objective of this study was to assess the impact on quality of life after rubber band ligation (RBL) in patients with symptomatic grade II-III haemorrhoids who did not improve after 6 months of conservative treatment, using quality of life scores. METHODS: This was a prospective cohort observational study where patients with haemorrhoidal disease and indication for RBL were included between December 2019 and December 2020. RBL was offered as first-line treatment in this group. Patient´s quality of life was assessed by scores: HDSS (Hemorrhoidal Disease Symptom Score) and SHS (Short Health Scale).Secondary objectives were: to evaluate the rate of patients requiring one or more RBL procedures, to establish the overall success rate of RBL and to analyse complications. RESULTS: A total of 100 patients were finally included. Regarding the impact on quality of life after RBL, a significant reduction was found in the HDSS and SHS scores (p < 0.001). The main improvement was found in the first month and it was maintained until the sixth month. A high degree of satisfaction with the procedure was reported by 76% of patients. The overall success rate of banding was 89%. A 12% complication rate was detected, the most frequent complication was severe anal pain (58.3%) and self-limiting bleeding (41.7%). CONCLUSION: Rubber band ligation, as a treatment for symptomatic grade II-III haemorrhoids that do not respond to medical treatment, leads to a significant improvement in patients' symptoms and quality of life. It also has a high degree of satisfaction between patients.

Effects of the COVID-19 Health Crisis on Sports Practice, Life Quality, and Emotional Status in Spanish High-Performance Athletes.

Spain is one of the many countries highly affected by the COVID-19 crisis, establishing very restrictive measures with a complete lockdown for more than 3 months. This situation forced the complete closure of sport practice and national or international competitions, leading to a negative impact on physical and psychological health of high-performance athletes. Therefore, the objectives of this study were (a) to determine the effects of the COVID-19 health crisis on Spanish high-performance athletes in terms of sports practice, life quality, and emotional state and (b) to identify the profile with the greatest difficulties during and after the lockdown. A sample of 130 high-performance athletes aged between 18 and 34 years (67 women and 63 men) participated in this study (83.1% achieved a medal in National-International elite competitions; 86.9% were considered student-athletes). Measures included socio-demographic data through a 5-dimension ad hoc survey: physical activity and exercise using an adapted version from the International Physical Activity Questionnaire (IPAQ); health status and limitations using an adapted version of SF-12 Health Questionnaire; Perceived stress (Short-PSS); and Mood States (29-item POMS). All participants have shown a significant decrease pre-post-lockdown in both health and performance perception, especially in women, individual athletes, medalists, and student-athletes. Strong limitations of training, attention, and motivation as well as a moderate negative emotional state during lockdown were reported, in women, individual athletes, medalists, and student-athletes. Even with an improved emotional state and energy level in the post-lockdown period, moderate-to-high stress scores were reported by women and medalists. Our findings highlight the importance of paying attention to the physical and psychological health of elite athletes on three profiles: team athletes (due to social distance), student-athletes (dual-career issues), and women athletes (prevalence of implicit gender inequalities in sport).

Factors Influencing Total Serum IgE in Adults: The Role of Obesity and Related Metabolic Disorders.

BACKGROUND AND AIM: Few reports have investigated the association between metabolic abnormalities (obesity and related metabolic syndrome) and total serum IgE concentrations. METHODS: This cross-sectional study included a random sample of 1,516 adult individuals (44.7% men, aged 18-91 years, median 52 years) from a single municipality in Spain. Serum IgE was measured in the ADVIA Centaur system. Atopy was defined by the presence of positive skin prick tests to a panel of common aeroallergens in the area. Body mass index and data related to the definition of metabolic syndrome were obtained from all participants. Alcohol consumption, smoking, and regular physical exercise were assessed by a questionnaire. RESULTS: Atopy (present in 21.9% of 1,514 evaluable individuals) was the strongest factor determining serum IgE concentrations. Male sex and heavy alcohol drinking were independently associated with higher IgE concentrations, particularly in the non-atopic individuals. Body mass index was positively associated with IgE concentrations, independent of potential confounders, although the effect was only evident among non-atopic individuals. In that group, median IgE concentrations in normal-weight and obese individuals were 15 and 24 kU/L, respectively (p < 0.001); likewise, obesity was associated with high (>100 kU/L) IgE concentrations after adjusting for potential confounders (odds ratio: 1.79, 95% confidence interval: 1.26-2.56, p = 0.001). The presence of metabolic syndrome and its components, particularly abdominal obesity and hyperglycaemia, was also positively and independently associated with higher IgE concentrations in non-atopic individuals. CONCLUSIONS: Obesity and metabolic syndrome components are associated with high total serum IgE concentrations, particularly in non-atopic individuals.

Ascitis quilosa tras colecistectomía: presentación de un caso / Chylous ascites after cholecystectomy: case report and literatura review

INTRODUCCIÓN: La ascitis quilosa es la presencia de líquido linfático en la cavidad peritoneal. Como consecuencia de una cirugía abdominal es muy infrecuente, encontrando 5 casos previos en la literatura revisada tras colecistectomía. OBJETIVO: Presentar un caso clínico de ascitis quilosa poscolecistectomía, su manejo y una revisión de la literatura. MATERIALES Y MÉTODOS: Varón de 77 años, quiloperitoneo 21 días después de realización de colecistectomía programada por colecistitis aguda. Resultados: Se realiza drenaje percutáneo con débito de 5 L en 24 horas, se inicia octreótido subcutáneo y nutrición parenteral total. Al tercer día disminuye el débito por el drenaje, por lo que se inicia dieta rica en triglicéridos de cadena media con buena evolución posterior. De los 5 casos previos tras colecistectomía, el 60% se resolvió con tratamiento conservador, un paciente precisó reintervención y otro colocación de un shunt portosistémico intrahepático trasnyugular (TIPSS). CONCLUSIÓN: La ascitis quilosa es una complicación postquirúrgica infrecuente, encontrando solo 5 casos previos tras colecistectomía. Inicialmente el manejo debe ser conservador, en caso de persistencia se deben valorar otras medidas.

INTRODUCTION: Chylous ascites is defined as the presence of lymph fluid in the peritoneal cavity. It is a rare complication after abdominal surgery; only 5 previously reported cases were found after cholecystectomy. Aim: Present a case report and a literature review. MATERIALS AND METHOD: Case report of a 77 year old male who underwent an elective cholecystectomy due to acute cholecystitis. Chyloperitoneum showed up 21 days after surgery. RESULTS: We performed a percutaneous drainage and 5 L of fluid were removed in 24 hours. We started treatment with subcutaneous Octreotide and total parenteral nutrition. After 3 days drain output decreased and we started a medium-chain triglycerides diet with good progress. The outcome of 60% of the 5 previous case reports of chyloperitoneum after cholecystitis, were successful with conservative management, surgical intervention was needed in one patient and a transjugular intrahepatic portosystemic shunt (TIPSS) was placed in another patient. CONCLUSION: Chylous ascites is a rare complication after surgery, there are only 5 previously case reports after cholecystectomy. Conservative management has to be the first option and in case of persistence another therapy has to be considered.

La actividad física y el deporte saludable en exdeportistas de élite / Former elite athletes' current sport and physical activity / Atividade física e esporte saudável em ex-atletas de elite

El propósito de este trabajo es doble. Por un lado, pretende describir los aspectos motivacionales y beneficios que obtienen los exdeportistas de élite que se mantienen físicamente activos después de la retirada y las barreras que perciben los exdeportistas físicamente inactivos, comparando los niveles de actividad física que reportan ambos grupos. Por otro lado, probar las relaciones entre los diferentes tipos de motivos y regulaciones conductuales que pueden predecir la práctica de actividad física saludable y deporte recreativo de los exdeportistas de élite. Se realizó un estudio transversal. Participaron 317 exdeportistas de élite (Medad = 36.5, DS = 7.18 años) completaron un cuestionario en línea que evaluaba motivos, regulaciones conductuales, cantidad de ejercicio, estados de cambio, beneficios y barreras. Respecto a la regulación conductual, los exdeportistas mostraron altos niveles de motivación intrínseca y regulación identificada y bajos de regulación extrínseca y amotivación. Los beneficios principales de practicar actividad física saludable y deporte recreativo fueron la diversión, la revitalización y la buena salud. Los exdeportistas físicamente inactivos (12.9%) detectaron como barreras principales los conflictos con otras actividades, su forma física actual y el hecho de haber perdido acceso a recursos e instalaciones. Los exdeportistas físicamente activos mostraron un perfil con niveles más altos de motivos intrínsecos, regulación interna y actividad física que los inactivos. Por su parte, los inactivos reportaron niveles significativamente más altos de motivos extrínsecos y amotivación. Proponemos que para promover actividad física saludable y deporte recreativo en la población de exdeportistas inactivos los programas de promoción deberían enfatizar la buena salud, el reconocimiento social y la competición, motivos todos ellos que predicen positivamente la regulación intrínseca y la actividad física autoinformada

The purpose of this study is twofold: (a) to describe the motivational aspects and gains obtained by physically active former elite athletes andthe barriers experienced by inactive former elite athletes comparing their reported exercise amount, and (b)to testwhether the different motivationswould predict their reported exercise amount. Using a cross-sectional survey design, 317 former athletes (Mage = 36.5, SD = 7.18 years) completed an online questionnaire assessing motivation, self-reported exercise and sport practice, stages of change, gains, and barriers. The main gains reported by former athletes were enjoyment, revitalization and positive health. Physically inactive former athletes (12.9%) spotted as the main barriers conflict with other activities, current physical fitness and lost accessto facilities and resources. To promote healthy physical activity in the physically inactive population of former elite athletes, policy makers and physical activity organizers should emphasize positive health, social recognition and competition motives, which positively predict intrinsic regulation and vigorous physical activity

O objetivo deste artigo é duplo: (a) descrever os aspectos motivacionais e benefícios obtidos por exdeportistas elite é fisicamente ativo e barreiras percebidas por fisicamente inativos, e (b) a testar um modelo motivacional que pode prever prática de atividade física nesta população. Um estudo transversal foi realizado. Havia 317 ex-atletas de elite (Medad = 36,5, DS = 7,18 anos). Eles preencheram um questionário on-line de motivações, quantidade de exercício, estados de mudança, benefícios e barreiras. Os principais benefícios foram diversão, revitalização eboa saúde. As principais barreiras para os inativos (12,9%) foram os conflitos com outras atividades, sua forma física atual e o fato de ter perdido acesso a recursos e instalações. Para promover a atividade física saudável na população de ex-atletas inativos, os programas de promoção devem enfatizar a boa saúde, o reconhecimento social e a competição, que preveem positivamente a regulação intrínseca e a atividade física

Infantile hemangioma with minimal or arrested growth as the skin manifestation of PHACE syndrome.

BACKGROUND: Infantile hemangiomas with minimal or arrested growth are vascular tumors with a proliferative component involving < 25% of their total surface area. They are commonly described as localized lesions and are mainly located on the lower body. Little has been described about segmental forms on the face and their associations with PHACE syndrome. METHODS: We carried out a multicenter, retrospective, case-series study involving 5 hospitals in Spain. Information was collected on cases of PHACE syndrome featuring infantile hemangiomas with minimal or arrested growth. RESULTS: The frontotemporal and maxillary areas were the most frequently involved sites in our series. The upper eyelid and upper lip were the 2 locations most frequently associated with proliferation and ulceration. Four patients experienced spontaneous resolution, and the rest had a very good cosmetic outcome with oral treatment. Cerebral and cervical arterial anomalies were the most frequent extracutaneous findings associated with PHACE, followed by cerebral and ocular anomalies. Some unique associated disorders were fructose intolerance and retinoblastoma. CONCLUSION: We present the largest case series of segmental facial infantile hemangiomas with minimal or arrested growth in PHACE syndrome and emphasize the importance of recognizing these lesions in early infancy, because they can indicate PHACE syndrome. The data presented suggest that infantile hemangiomas with minimal or arrested growth-associated PHACE syndrome does not seem to differ significantly from PHACE syndrome with classic infantile hemangiomas, and thus the same recommendations for diagnosis, management, and therapy should be followed. Future studies with more patients could contribute to enlighten this specific subset.

Eficacia en la aplicación de las medidas de formación para los deportistas de alto nivel en el territorio español / Efficiency of the application of academic training policies for spanish top athletes / Eficácia na aplicação de medidas de formação para desportistas de alto rendimento em território espanhol

La formación académica y la planificación son fundamentales para una exitosa inserción laboral de los atletas de élite. El objetivo de este estudio fue detectar el nivel de aplicación de las medidas de formación por los diferentes agentes que participan en el sistema. Al analizar el proceso de información se apreciaron ciertas carencias en el mismo. El cambio de fechas de exámenes con motivo de competiciones/concentraciones oficiales fue el aspecto más demandado por los diferentes deportistas. Dado que el periodo de los 20 a los 30 años es crítico para la formación, sería necesario aportar un servicio de cobertura total para la población de deportistas de Alto Nivel, con el fin de dar un asesoramiento permanente y trazar una línea continua desde la vida deportiva a la vida laboral en los deportistas

Academic training and planning are fundamental in ensuring the integration of elite athletes into the labour market. The main goal of this study was to analyse the extent to which academic measures are applied by the system’s different stakeholders. When the information process was analysed, certain shortcomings were noted. Most calls by athletes were for the dates of exams to be changed due to their coincidence with an official competition, as confirmed by requests to all bodies. The period from 20 to 30 years of age is critical in academic terms and a fully comprehensive service should be ensured for these top athletes in order to provide ongoing guidance

A formação académica e a planificação são fundamentais para uma bem sucedida inserção laboral dos atletas de elite. O objectivo deste estudo foi detectar o nível de aplicação de medidas de formação pelos diferentes agentes desportivos que participam no sistema. Ao analisar o processo de informação foram identificadas algumas carências no mesmo. A mudança das datas dos exames por motivos de competições/concentrações oficiais foi o aspecto mais pedido pelos diferentes desportistas. Dado que o período dos 20 aos 30 anos é crítico para a formação, seria necessário adicionar um serviço de cobertura total para a população de desportistas de Alto Rendimento, com o objectivo de assessorar permanentemente e traçar uma linha contínua desde a vida desportiva à vida laboral dos desportistas

Importance of facial physical attractiveness of audiovisual models in descriptions and preferences of children and adolescents.

We performed a cross-sectional study with three age groups (8, 14, and 17 years) to evaluate developmental differences in stereotyped beliefs about physical attractiveness and the value of this as perceived by the participants. Given the current importance of television in the development of social knowledge, television models were used. The children and adolescents were asked to evaluate, using bipolar open scales, the physical attractiveness, likeableness, generosity, intelligence, fun, and altruism of 12 television models of both sexes, previously selected by judges, as well as the desire to resemble or feel close to the models. Analysis showed developmental differences across age groups both in the concept of physical attractiveness and in stereotyped beliefs about this. As in other areas of social knowledge, the younger children's responses were bipolar, global, and much more stereotyped, while the adolescents introduced subtle distinctions and elaborated their responses. Nevertheless, physical attractiveness appeared a desirable characteristic for all age groups.