Trends in the incidence of hospital-treated suicide attempts during the COVID-19 pandemic in Oviedo, Spain.

BACKGROUND: The potential impact of the COVID-19 pandemic on suicidal behavior has generated predictions anticipating an increase in suicidal tendencies. The aim of this research is to study its influence on the incidence of hospital-treated suicide attempts throughout the year 2020 in Oviedo, Spain. METHODS: Data were collected on all patients admitted to the emergency department of Central University Hospital of Asturias in Oviedo for attempted suicide during 2020. Incidence rates were calculated for three lockdown periods. Suicide attempt trends in 2020 were compared with a non-COVID-19 year (2009) to avoid seasonal variations bias. Chi-square and Fisher's exact tests were performed. The influence of COVID-19 incidence in Oviedo was analyzed using Spearman's correlation coefficient. RESULTS: The cumulative incidence rate of attempted suicide per 100,000 person-years was 136.33 (pre-lockdown), 115.15 (lockdown), and 90.25 (post-lockdown) in adults (over 19 years old), and 43.63 (pre-lockdown), 32.72 (lockdown), and 72.72 (post-lockdown) in adolescents (10-19 years old). No association was found with COVID-19 incidence rates (Spearman's rho -0.222; p = 0.113). Comparing the years 2020 and 2009, statistically significant differences were observed in adolescents (Fisher's exact test; p = 0.024), but no differences were observed in adults (chi-square test = 3.0401; p = 0.218). CONCLUSIONS: Hospital-treated suicide rates attempted during the COVID-19 outbreak in Oviedo, Spain showed a similar trend compared with a non-COVID-19 year. In contrast, the number of adolescents hospital-treated for attempted suicide increased during lockdown, suggesting more vulnerability to COVID-19 restrictions after the initial lockdown period in this age group.

Radioguided surgery with iodine-125 seeds in breast cancer patients treated with neoadjuvant chemotherapy.

OBJECTIVE: To evaluate the use of radioactive iodine-125 seed (RIS) in breast and/or axillary surgery, in patients with breast cancer treated with neoadjuvant chemotherapy (NAC). MATERIAL AND METHODS: Prospective study between January 2016 and June 2020. 80 women T1-3,N0-2,M0: 30 RIS marking the breast tumor, 36 both the tumor and the biopsied positive axillary node, and 14 only the axilla. Age: 54.7 ±â€¯11.4 years. Tumor size: 34.1 ±â€¯14.6 mm. Histological type: invasive ductal carcinoma 90.0%. Molecular subtypes: luminal-A 23.8%, luminal-B/HER2- 33.7%, luminal-B/HER2+ 18.8%, HER2+ 7.5%, basal-like 16,2%. RESULTS: Of the 66 patients with RIS marking of the tumor (51 pre-NAC, 15 post-NAC), 92.1% had tumor-free surgical margins, with a specimen volume of 126.7 ±â€¯111.2 cm3. Of the 5 s local excisions, in 3 the resection margin was involved (1 mastectomy). Of the 50 patients N1 with RIS marking (MLN), 44 pre-NAC and 6 post-NAC, MLN was identified in 97.2%: negative 23, positive 26. In 45/50 patients, sentinel node biopsy (SNB) was performed and it was identified in 93.3%: negative 26, positive 16. In 1 case RIS was not placed correctly and SNB was not identified due to non-migration. In 61.9% of the patients, MLN was among the SNB identified in the surgery. In 5 patients with mismatched SNB and MLN, the pathological result of the SNB was negative and the MLN was positive. Axillary lymph node dissection was performed in 53.8% of the patients. CONCLUSION: RIS allow to perform breast-conserving surgery and improve detection of residual axillary disease in patients treated with NAC.

Estudio multicéntrico de la reparación endovascular urgente de la aorta torácica: indicaciones y resultados / A multicenter study of emergency endovascular repair of the thoracic aorta: indications and outcomes

Objetivo Las técnicas endovasculares se han convertido en una herramienta esencial para el tratamiento de la patología de aorta torácica descendente (TEVAR). El objetivo es analizar las indicaciones y resultados del TEVAR urgente a nivel nacional en relación con la cirugía programada. Diseño y ámbito de estudio Registro multicéntrico retrospectivo de pacientes con patología de aorta torácica descendente tratados de urgencia mediante técnicas endovasculares entre los años 2012-2016 en 11 servicios clínicos. Pacientes, criterios de inclusión 1) Aneurismas de aorta torácica rotos, 2) roturas traumáticas de aorta torácica y 3) disecciones de aorta torácica tipo B (DATBc) complicadas. Variables principales Mortalidad, supervivencia y tasa de reintervenciones. Variables secundarias Datos demográficos, factores de riesgo cardiovasculares, datos específicos por indicación, datos técnicos y complicaciones postoperatorias. Resultados Se obtuvieron 135 TEVAR urgentes (111 varones, edad media 60,4 ± 16,3 años): 43 aneurismas aórticos rotos (31,9%), 54 disecciones tipo B (40%) y 32 roturas aórticas traumáticas (23,7%) y otras etiologías 4,4%. La mortalidad global a los 30 días fue del 18,5%, siendo superior en los aneurismas de aorta torácica rotos (27,9%). La supervivencia media actuarial ha sido del 67± 6% a los 5 años. La tasa de ictus postoperatoria fue del 5,2% y la tasa de isquemia medular del 5,9%. Las reintervenciones aórticas fueron necesarias en 12 pacientes (9%). Conclusiones La patología de aorta descendente urgente puede ser tratada mediante técnicas endovasculares con resultados óptimos y baja morbimortalidad, aunque ligeramente superior a los casos electivos. Este registro aporta por primera vez, información de la realidad clínica diaria del TEVAR urgente en España. (AU)

Objective Endovascular techniques have become an essential tool for the treatment of descending thoracic aortic disease (thoracic endovascular aneurysm repair [TEVAR]). The aim is to analyze the indications and outcomes of emergency TEVAR at national level in relation to elective surgery. Study design and scope A retrospective multicenter registry of patients with descending thoracic aortic disease treated on an emergency basis using endovascular techniques between 2012-2016, in 11 clinical units. Patients, inclusion criteria 1) Ruptured descending thoracic aortic aneurysms; 2) Blunt traumatic thoracic aortic injury; and 3) Complicated acute type B aortic dissections (TBADc). Primary variables Patient mortality, survival and reoperation rate. Secondary variables Demographic data, cardiovascular risk factors, specific data by indication, technical resources and postoperative complications. Results A total of 135 urgent TEVARs were included (111 men, mean age 60.4 ± 16.3 years): 43 ruptured thoracic aortic aneurysms (31.9%), 54 type B dissections (40%) and 32 traumatic aortic injuries (23.7%), and other etiologies 4.4%. The overall mortality rate at 30 days was 18.5%, and proved higher in the ruptured descending thoracic aortic aneurysms group (27.9%). The mean actuarial survival rate was 67± 6% at 5 years. The postoperative stroke rate was 5.2%, and the paraplegia rate was 5.9%. Aortic reoperations proved necessary in 12 patients (9%). Conclusions Emergency descending thoracic aortic diseases can be treated by endovascular techniques with optimal results and low morbidity and mortality – though the figures are slightly higher than in elective cases. This registry provides, for the first time, real information on the daily clinical practice of emergency TEVAR in Spain. (AU)

A multicenter study of emergency endovascular repair of the thoracic aorta: Indications and outcomes.

OBJECTIVE: Endovascular techniques have become an essential tool for the treatment of descending thoracic aortic disease (thoracic endovascular aneurysm repair [TEVAR]). The aim is to analyze the indications and outcomes of emergency TEVAR at national level in relation to elective surgery. STUDY DESIGN AND SCOPE: A retrospective multicenter registry of patients with descending thoracic aortic disease treated on an emergency basis using endovascular techniques between 2012-2016, in 11 clinical units. PATIENTS, INCLUSION CRITERIA: 1) Ruptured descending thoracic aortic aneurysms (RTAA); 2) Blunt traumatic thoracic aortic injury (TAI); and 3) Complicated acute type B aortic dissections (TBADc). PRIMARY VARIABLES: Patient mortality, survival and reoperation rate. SECONDARY VARIABLES: Demographic data, cardiovascular risk factors, specific data by indication, technical resources and postoperative complications. RESULTS: A total of 135 urgent TEVARs were included (111 men, mean age 60.4 ±â€¯16.3 years): 43 ruptured thoracic aortic aneurysms (31.9%), 54 type B dissections (40%) and 32 traumatic aortic injuries (23.7%), and other etiologies 4.4%. The overall mortality rate at 30 days was 18.5%, and proved higher in the RTAA group (27.9%). The mean actuarial survival rate was 67 ±â€¯6% at 5 years. The postoperative stroke rate was 5.2%, and the paraplegia rate was 5.9%. Aortic reoperations proved necessary in 12 patients (9%). CONCLUSIONS: Emergency descending thoracic aortic diseases can be treated by endovascular techniques with optimal results and low morbidity and mortality - though the figures are slightly higher than in elective cases. This registry provides, for the first time, real information on the daily clinical practice of emergency TEVAR in Spain.

Characterization of Anthocyanins From Intraspecific Crosses of Monastrell With Other Premium Varieties.

One way in which the wine sector is reacting to the challenge of climate change is to develop plant material that is adapted to the new conditions. Such a strategy will allow the continuation of quality viticulture in traditional winemaking areas that will otherwise be abandoned. The objective of this study was to characterize the anthocyanin composition and content of selected intraspecific hybrids of Monastrell with two other varieties (Syrah and Cabernet Sauvignon). The experiment was carried out over three successive seasons, and the polyphenolic quality of the grapes and wines was assessed along with the adaptation of the hybrids to the high temperatures which will inevitably affect our area (south-eastern Spain). The results showed that, compared with grapes of the Monastrell variety and the wines made from them, most of the hybrids (MS10, MS34, and MC111) had a higher total anthocyanin concentration and overall content of acylated anthocyanins, depending on the year studied.

Radioguided surgery with iodine-125 seeds in breast cancer patients treated with neoadjuvant chemotherapy. / Cirugía radioguiada con semillas de yodo-125 en pacientes con cáncer de mama tratadas con quimioterapia neoadyuvante.

OBJECTIVE: To evaluate the use of radioactive iodine-125 seed (RIS) in breast and/or axillary surgery, in patients with breast cancer treated with neoadjuvant chemotherapy (NAC). MATERIAL AND METHODS: Prospective study between January 2016 and June 2020. 80 women T1-3,N0-2,M0: 30 RIS marking the breast tumor, 36 both the tumor and the biopsied positive axillary node, and 14 only the axilla. Age: 54.7±11.4 years. Tumor size: 34.1±14.6mm. Histological type: invasive ductal carcinoma 90.0%. Molecular subtypes: luminal-A 23.8%, luminal-B/HER2- 33.7%, luminal-B/HER2+ 18.8%, HER2+ 7.5%, basal-like 16,2%. RESULTS: Of the 66 patients with RIS marking of the tumor (51 pre-NAC, 15 post-NAC), 92.1% had tumor-free surgical margins, with a specimen volume of 126.7±111.2 cm3. Of the 5 second local excisions, in 3 the resection margin was involved (1 mastectomy). Of the 50 patients N1 with RIS marking (MLN), 44 pre-NAC and 6 post-NAC, MLN was identified in 97.2%: negative 23, positive 26. In 45/50 patients, sentinel node biopsy (SNB) was performed and it was identified in 93.3%: negative 26, positive 16. In 1 case RIS was not placed correctly and SNB was not identified due to non-migration. In 61.9% of the patients, MLN was among the SNB identified in the surgery. In 5 patients with mismatched SNB and MLN, the pathological result of the SNB was negative and the MLN was positive. Axillary lymph node dissection was performed in 53.8% of the patients. CONCLUSION: RIS allow to perform breast-conserving surgery and improve detection of residual axillary disease in patients treated with NAC.

A multicenter study of emergency endovascular repair of the thoracic aorta: indications and outcomes. / Estudio multicéntrico de la reparación endovascular urgente de la aorta torácica: indicaciones y resultados.

OBJECTIVE: Endovascular techniques have become an essential tool for the treatment of descending thoracic aortic disease (thoracic endovascular aneurysm repair [TEVAR]). The aim is to analyze the indications and outcomes of emergency TEVAR at national level in relation to elective surgery. STUDY DESIGN AND SCOPE: A retrospective multicenter registry of patients with descending thoracic aortic disease treated on an emergency basis using endovascular techniques between 2012-2016, in 11 clinical units. PATIENTS, INCLUSION CRITERIA: 1) Ruptured descending thoracic aortic aneurysms; 2) Blunt traumatic thoracic aortic injury; and 3) Complicated acute type B aortic dissections (TBADc). PRIMARY VARIABLES: Patient mortality, survival and reoperation rate. SECONDARY VARIABLES: Demographic data, cardiovascular risk factors, specific data by indication, technical resources and postoperative complications. RESULTS: A total of 135 urgent TEVARs were included (111 men, mean age 60.4 ± 16.3 years): 43 ruptured thoracic aortic aneurysms (31.9%), 54 type B dissections (40%) and 32 traumatic aortic injuries (23.7%), and other etiologies 4.4%. The overall mortality rate at 30 days was 18.5%, and proved higher in the ruptured descending thoracic aortic aneurysms group (27.9%). The mean actuarial survival rate was 67± 6% at 5 years. The postoperative stroke rate was 5.2%, and the paraplegia rate was 5.9%. Aortic reoperations proved necessary in 12 patients (9%). CONCLUSIONS: Emergency descending thoracic aortic diseases can be treated by endovascular techniques with optimal results and low morbidity and mortality - though the figures are slightly higher than in elective cases. This registry provides, for the first time, real information on the daily clinical practice of emergency TEVAR in Spain.

Comparison of hip extension and rotation ranges of motion in young elite tennis players with and without history of low back pain.

BACKGROUND: Although low back pain (LBP) is known to be multi-factorial, certain studies have suggested that a deficit in hip extension and rotation range of motion (ROM) may be associated with LBP in athletes. OBJETIVE: The purpose of this study was to compare hip extension and rotation ROMs in elite tennis players with and without a history of LBP. METHODS: Forty-two male and 22 female young elite tennis players completed this study. Participants were divided into two groups: (1) 32 with history of LBP and (2) 32 without history of LBP. Descriptive measures of passive hip extension and rotation ROMs of the dominant and non-dominant limbs were taken. Active hip rotation ROMs were also assessed. Magnitude-based inferences on differences between groups and legs were made by standardizing differences. RESULTS: The inter-group statistical analysis reported no significant differences (p> 0.05; trivial effect with a probability higher than 95%; d⩽ 0.4) in any ROM measure analyzed. Further, neither LBP group nor control group reported significant bilateral or side-to-side differences (p> 0.05; trivial effect with a probability higher than 99%; d< 0.3) between legs regarding hip extension and rotation ROM measures. CONCLUSION: No relationship between hip extension and rotation ROM and history of LBP was found.

Influence of methyl jasmonate and benzothiadiazole on the composition of grape skin cell walls and wines.

Phenolic compounds are very important in crop plants, particularly in grapes. The different strategies to increase their levels include the use of elicitors such as methyl jasmonate (MeJ) and benzothiadiazole (BTH). In an attempt to improve the quality of wines, our aim was to evaluate the effect of preharvest application of these elicitors on the composition and structure of the skin cell walls of Monastrell, Merlot and Cabernet Sauvignon grapes, and to ascertain any relationship with the extractability of phenolic compounds during winemaking. The results indicated that the exogenous application of MeJ and BTH during veraison caused significant changes in several components of the skin cell walls, such as phenolic compounds, proteins and structural sugars. However these changes manifested themselves in different proportions in each variety and year, pointing to the varietal and meteorological dependence of the response to the application of these elicitors. The treatments delayed the maturation process in all varieties when rainfall was low. This observation, together with the observed increase in proteins and phenols in the skin cell wall of Monastrell and Cabernet Sauvignon, could contribute to the strength necessary to maintain the integrity of berries and to increasing resistance to fungal pathogens as the phenolic compounds evolve, thus improving the phenolic profile. However, the structural integrity of Merlot variety tended to decrease in the same conditions.

Utilización de tocilizumab en la esclerosis sistémica: breve revisión de la literatura / Use of tocilizumab in systemic sclerosis: A brief literature review

Los tratamientos disponibles para la esclerosis sistémica (ES) tienen una efectividad limitada. Recientemente se ha propuesto el tratamiento con tocilizumab (TCZ), un fármaco biológico que inhibe la interleucina 6 (IL6). En este trabajo se realiza una revisión de la literatura para evaluar la eficacia y seguridad de TCZ en ES. Se han encontrado 52 artículos, de los que, tras su evaluación, se han seleccionado solo 10. En un ensayo clínico aleatorizado TCZ demostró una mejoría no significativa del grado de induración cutánea, mientras que en un estudio observacional los resultados fueron neutros. En dicho ensayo clínico, los parámetros funcionales respiratorios mostraron cierto grado de estabilización. El perfil de seguridad de TCZ es aceptable. La evidencia actual en cuanto al tratamiento de la ES con TCZ es muy limitada, aunque el fármaco podría tener un efecto beneficioso en la afectación cutánea. Se requieren nuevos ensayos clínicos para comprobar su utilidad en ES

The available treatments for systemic sclerosis (SS) have limited effectiveness. Treatment with tocilizumab (TCZ), a biological drug that inhibits interleukin 6 (IL-6), has recently been proposed. In this study, we conducted a literature review to assess the safety and efficacy of TCZ in SS. We found 52 articles, 10 of which we selected after evaluating the articles. In a randomised clinical trial, TCZ showed a nonsignificant improvement in the degree of skin induration, while another observational study showed neutral results. In this same clinical trial, the functional respiratory parameters showed a certain degree of stabilization. The safety profile of TCZ is acceptable; however, the current evidence regarding treatment of SS with TCZ is highly limited, although the drug could have a beneficial effect in skin disorder. New clinical trials are needed to determine the usefulness of TCZ in SS

Use of tocilizumab in systemic sclerosis: A brief literature review. / Utilización de tocilizumab en la esclerosis sistémica: breve revisión de la literatura.

The available treatments for systemic sclerosis (SS) have limited effectiveness. Treatment with tocilizumab (TCZ), a biological drug that inhibits interleukin 6 (IL-6), has recently been proposed. In this study, we conducted a literature review to assess the safety and efficacy of TCZ in SS. We found 52 articles, 10 of which we selected after evaluating the articles. In a randomised clinical trial, TCZ showed a nonsignificant improvement in the degree of skin induration, while another observational study showed neutral results. In this same clinical trial, the functional respiratory parameters showed a certain degree of stabilization. The safety profile of TCZ is acceptable; however, the current evidence regarding treatment of SS with TCZ is highly limited, although the drug could have a beneficial effect in skin disorder. New clinical trials are needed to determine the usefulness of TCZ in SS.

A COMPARATIVE STUDY OF PASSIVE SHOULDER ROTATION RANGE OF MOTION, ISOMETRIC ROTATION STRENGTH AND SERVE SPEED BETWEEN ELITE TENNIS PLAYERS WITH AND WITHOUT HISTORY OF SHOULDER PAIN.

BACKGROUND: Glenohumeral internal rotation deficit and external rotation strength have been associated with the development of shoulder pain in overhead athletes. OBJECTIVE: To examine the bilateral passive shoulder rotational range of motion (ROM), the isometric rotational strength and unilateral serve speed in elite tennis players with and without shoulder pain history (PH and NPH, respectively) and compare between dominant and non-dominant limbs and between groups. STUDY DESIGN: Cohort study. METHODS: Fifty-eight elite tennis players were distributed into the PH group (n = 20) and the NPH group (n = 38). Serve velocity, dominant and non-dominant passive shoulder external and internal rotation (ER and IR) ROM, total arc of motion (TAM: the sum of IR and ER ROM), ER and IR isometric strength, bilateral deficits and ER/IR strength ratio were measured in both groups. Questionnaires were administered in order to classify characteristics of shoulder pain. RESULTS: The dominant shoulder showed significantly reduced IR ROM and TAM, and increased ER ROM compared to the non-dominant shoulder in both groups. Isometric ER strength and ER/IR strength ratio were significantly lower in the dominant shoulder in the PH group when compared with the NPH group. No significant differences between groups were found for serve speed. CONCLUSION: These data show specific adaptations in the IR, TAM and ER ROM in the dominant shoulder in both groups. Isometric ER muscle weakness and ER/IR strength ratio deficit appear to be associated with history of shoulder injuries in elite tennis players. It would be advisable for clinicians to use the present information to design injury prevention programs. LEVEL OF EVIDENCE: 2.

The effects of training with loads that maximise power output and individualised repetitions vs. traditional power training.

BACKGROUND: It has been suggested that strength training effects (i.e. neural or structural) vary, depending on the total repetitions performed and velocity loss in each training set. PURPOSE: The aim of this study is to compare the effects of two training programmes (i.e. one with loads that maximise power output and individualised repetitions, and the other following traditional power training). METHODS: Twenty-five males were divided into three groups (optimum power [OP = 10], traditional training [TT = 9] and control group [CG = 6]). The training load used for OP was individualised using loads that maximised power output (41.7% ± 5.8 of one repetition maximum [1RM]) and repetitions at maximum power (4 to 9 repetitions, or 'reps'). Volume (sets x repetitions) was the same for both experimental groups, while intensity for TT was that needed to perform only 50% of the maximum number of possible repetitions (i.e. 61.1%-66.6% of 1RM). The training programme ran over 11 weeks (2 sessions per week; 4-5 sets per session; 3-minute rests between sets), with pre-, intermediate and post-tests which included: anthropometry, 1RM, peak power output (PPO) with 30%, 40% and 50% of 1RM in the bench press throw, and salivary testosterone (ST) and cortisol (SC) concentrations. Rate of perceived exertion (RPE) and power output were recorded in all sessions. RESULTS: Following the intermediate test, PPO was increased in the OP group for each load (10.9%-13.2%). Following the post-test, both experimental groups had increased 1RM (11.8%-13.8%) and PPO for each load (14.1%-19.6%). Significant decreases in PPO were found for the TT group during all sets (4.9%-15.4%), along with significantly higher RPE (37%). CONCLUSION: OP appears to be a more efficient method of training, with less neuromuscular fatigue and lower RPE.

[Massive cerebral air embolism following endoscopic retrograde cholangiopancreatography. A case report and review of the literature]. / Embolia aerea cerebral masiva tras colangiopancreatografia retrograda endoscopica. Presentacion de un caso y revision de la bibliografia.

INTRODUCTION: Cerebral air embolism following endoscopic processes is an infrequent complication, but can have catastrophic consequences. CASE REPORT: An 85-year-old male diagnosed with distal cholangiocarcinoma with criteria for unresectability who was submitted to placement of a biliary drainage prosthesis. Endoscopic retrograde cholangiopancreatography was performed to change the prosthesis. After the procedure, the patient's vital signs and level of consciousness underwent a decline, and orotracheal intubation was required. A computerised axial tomography scan of the head showed evidence of a massive air embolism with focal points of hyperacute ischaemia in both hemispheres. The patient later died. CONCLUSIONS: Cerebral air embolism following endoscopic retrograde cholangiopancreatography is infrequent, but potentially lethal. Manipulation of the bilio-intestinal wall in endoscopic examinations could give rise to communications between the lumen and the venous system. This, together with the high insufflation pressure used to conduct this test, would condition the passage of air to the portal venous system, and from there to the circulatory system. In the central nervous system, air bubbles would lead to a vascular obstruction, with the subsequent ischaemia and necrosis of tissues. An early diagnosis and life support therapy are essential. Its timely management can contribute to a better prognosis which, at least initially, is gloomy.

TITLE: Embolia aerea cerebral masiva tras colangiopancreatografia retrograda endoscopica. Presentacion de un caso y revision de la bibliografia.Introduccion. La embolia aerea cerebral tras procesos endoscopicos es una complicacion infrecuente, pero que puede tener consecuencias catastroficas. Caso clinico. Varon de 85 años, diagnosticado de colangiocarcinoma distal con criterios de irresecabilidad, al cual se coloca una protesis biliar de drenaje. Se realiza una colangiopancreatografia retrograda endoscopica para el cambio de protesis. Tras el procedimiento, el paciente sufre un deterioro de las constantes vitales y del nivel de consciencia, y requiere intubacion orotraqueal. En la tomografia axial computarizada craneal se evidencia una embolia aerea masiva con focos de isquemia hiperaguda en ambos hemisferios. El paciente fallece posteriormente. Conclusiones. El embolismo aereo cerebral tras una colangiopancreatografia retrograda endoscopica es infrecuente, pero potencialmente letal. La manipulacion de la pared biliointestinal en las exploraciones endoscopicas podria originar comunicaciones entre la luz y el sistema venoso. Esto, unido a la alta presion de insuflacion para la realizacion de la prueba, condicionaria el paso de aire al sistema venoso portal y, de ahi, al sistema circulatorio. En el sistema nervioso central, las burbujas de aire provocarian una obstruccion vascular, con la consiguiente isquemia y necrosis del tejido. Es fundamental un diagnostico precoz y una terapia de soporte vital. Su rapido manejo puede contribuir a un mejor pronostico, que en principio es sombrio.

Acute responses and muscle damage in different high-intensity interval running protocols.

AIM: Our study aimed to evaluate the acute responses and exercise--induced muscle damage of five different high--intensity interval training (HIT) protocols adjusted by the maximum velocity obtained in the 30--15 Intermittent Fitness Test (V IFT ). METHODS: Sixteen well--trained intermittent sport players (mean ± SD;; age, 24.6 ± 2.7 years; V̇O 2max , 58.3 ± 5.9 ml∙min∙kg --1 ) participated in five different HIT protocols separated by six days in between (P 240 : 4×4 min at 80% V IFT ; P 120 : 7×2 min at 85%; P 30 : 2×10×30 s at 90%; P 15 : 3×9×15 s at 95%; P 5 : 4×6×5 s sprints). Blood lactate (La), blood pH, serum creatinkinase (CK), heart rate (HR), session rating of perceived exertion (session--RPE), delayed onset muscle soreness (DOMS) and countermovement jump (CMJ) height were measured. RESULTS: A significant main effect for protocol ( p < 0.05) was found for the acute responses of HR, session-RPE and La with values increasing in longer intervals from P 15 to P 120 and P 240 while blood pH responded inversely. In contrast, P 5 produced the highest La concentration and blood pH decreases. 24 h post exercise CK, DOMS and the decrease in CMJ height were significantly higher after P 5 compared to all other protocols ( p < 0.05). CONCLUSION: HIT protocols of different interval duration and intensity result in varying acute physiological and perceptual demands and exercise--induced muscle damage. Longer intervals with submaximal intensity lead to higher acute cardio circulatory responses, whereas sprint protocols induce the highest muscle damage and muscle soreness.