Role of sports psychology and sports nutrition in return to play from musculoskeletal injuries in professional soccer: an interdisciplinary approach.

Musculoskeletal injuries are prevalent in professional soccer and can result in lost training time or match play. It is intuitive that the "return to play" (RTP) pathway will depend, in large part, on the expertise of sports medicine practitioners (e.g. surgeons, physicians, physiotherapists) responsible for player's recovery. Consensus statements on returning athletes to sport following injury acknowledge the contributions of sport psychology and sports nutrition. However, specific consideration on how to integrate these two recognized - but often overlooked components of injury rehabilitation - into existing sport medicine approaches has yet to be examined. Using a framework of milestones directed by the medical physician and physical trainer, the evidence is summarized and suggestions provided on the integration of sports psychology and sports nutrition into an interdisciplinary RTP approach. We examine recovery from a phase approach (acute injury and functional recovery) to highlight interdisciplinary opportunities in the management of musculoskeletal soccer injuries. An interdisciplinary approach is understood to achieve outcomes that could not be achieved within the framework of a single discipline. The incorporation of sports psychology and nutrition theoretically compliment milestones used in current medically-based RTP models. Our hope is that this article serves as a catalyst for interdisciplinary practice and research - not only in sports nutrition and sports psychology - but across all sport and exercise disciplines.

Thymoglobulin Induction Therapy in Deceased Donor Kidney Transplantation: Single-Center Experience in Mexico.

BACKGROUND: Induction therapy is used to reduce the incidence of graft rejection and delayed graft function. Thymoglobulin is the most used inductor agent in deceased donor kidney transplantation due to its lower rejection and delayed graft function rates. METHODS: Retrospective study of patients who underwent deceased donor kidney transplantation from 2011 to 2014. Efficacy and safety outcomes evaluated were primary graft nonfunction, delayed graft function, acute rejection episodes, the lowest leukocyte count during the induction, adverse effects, eGFR, and patient and graft survival. P < .05 was considered statistically significant. RESULTS: A total of 42 patients were registered. Of these, 51.7% were female, with a mean age of 36.4 ± 11.1 years. Mean dialysis time was 112.4 ± 365 months. Mean donor age was 33.7 ± 13.1 years. Of the registered patients, 14.3% were extended criteria donors and 23.8% high-risk. Mean thymoglobulin dose was 4.4 ± 0.8 mg/kg. Primary graft nonfunction was 2.4%. Nineteen percent presented with delayed graft function and 19% with acute rejection. Mean lowest leukocyte count was of 4.6 ± 1.5 × 10(3) cells/mm(3). Mean hospital stay was 11.3 ± 6.3 days. Adverse effects were seen in 59.5% of registered patients, whereas graft survival 1 year and 3 years after transplantation was 85.3% and 56.9%, respectively. Patient survival 1 year and 3 years after transplantation was 85.3% and 53.8%, respectively. Patients who received a higher dose (>4.4 mg/kg) had a shorter hospital stay (9.4 ± 4.6 and 8.1 ± 2.3) than those who received lower dose (13.6 ± 7.9 and 12.8 ± 7.4; P < .05). CONCLUSION: Thymoglobulin induction at doses near 5 mg/kg in deceased donor kidney transplant is efficient and secure at our center.

A chromatographic objective function to characterise chromatograms with unknown compounds or without standards available.

Getting useful chemical information from samples containing many compounds is still a challenge to analysts in liquid chromatography. The highest complexity corresponds to samples for which there is no prior knowledge about their chemical composition. Computer-based methodologies are currently considered as the most efficient tools to optimise the chromatographic resolution, and further finding the optimal separation conditions. However, most chromatographic objective functions (COFs) described in the literature to measure the resolution are based on mathematical models fitted with the information obtained from standards, and cannot be applied to samples with unknown compounds. In this work, a new COF based on the automatic measurement of the protruding part of the chromatographic peaks (or peak prominences) that indicates the number of perceptible peaks and global resolution, without the need of standards, is developed. The proposed COF was found satisfactory with regard to the peak purity criterion when applied to artificial peaks and simulated chromatograms of mixtures built using the information of standards. The approach was applied to mixtures of drugs containing unknown impurities and degradation products and to extracts of medicinal herbs, eluted with acetonitrile-water mixtures using isocratic and gradient elution.

The application of the Yo-Yo intermittent endurance level 2 test to elite female soccer populations.

The aim of this study was to evaluate the application of the Yo-Yo intermittent endurance test level 2 (Yo-Yo IE2) to elite female soccer populations. Elite senior (n = 92), youth (n = 42), domestic (n = 46) and sub-elite female soccer players (n = 19) carried out the Yo-Yo IE2 test on numerous occasions across the season. Test-retest coefficient of variation (CV) in Yo-Yo IE2 test performance in domestic female players was 4.5%. Elite senior female players' Yo-Yo IE2 test performances were better (P < 0.01) than elite youth, domestic and sub-elite players (mean ± standard deviation; 1774 ± 532 vs 1490 ± 447, 1261 ± 449, and 994 ± 373 m). For elite senior female players, wide midfielders (2057 ± 550 m) had a higher Yo-Yo IE2 test performance (P < 0.05) than central defenders (1588 ± 534 m) and attackers (1516 ± 401 m), but not central midfielders (1764 ± 473 m) or full-backs (1964 ± 522 m). Large correlations were observed between Yo-Yo IE2 test performance and the total and high-intensity distance covered (r = 0.55; P < 0.05) during elite senior soccer matches (r = 0.70; P < 0.01). A large correlation was also obtained between Yo-Yo IE2 test performance and (r = 0.68; P < 0.01). Performances in the Yo-Yo IE2 test were greater (P < 0.05) in the middle and the end of the season compared with the preparation period for elite youth female players (1767 ± 539 and 1742 ± 503 vs 1564 ± 504 m) and in elite senior female players, Yo-Yo IE2 test performance increased by 14% (P < 0.01) after completing 4 weeks of intense training prior to the FIFA Women's World Cup Finals (2049 ± 283 vs 1803 ± 342 m). The data demonstrate that the Yo-Yo IE2 test is reproducible and is an indicator of the match-specific physical capacity of female soccer players. Furthermore, the Yo-Yo IE2 test illustrates sensitivity by differentiating intermittent exercise performance of female players in various competitive levels, stages of the season and playing positions.

Manipulación cervical: aproximación anatómico-biomecánica frente a los posibles riesgos e implicaciones prácticas / Cervical manipulation: anatomical and biomechanical approach facing possible risks and practical implications

La manipulación articular es una técnica fisioterápica con cierto "estatus" dentro de nuestro arsenal terapéutico, fruto de la promesa de buenos resultados a muy corto plazo de tiempo, el halo de misticismo que la envuelve, el miedo desencadenado por reacciones adversas durante su aplicación y el tipo de impulso a desarrollar. Aunque la bibliografía especializada casi siempre evidencie un único tipo de manipulación, la rotatoria, la manipulación puede realizarse mediante movimientos translatorios de tracción o deslizamiento que ofrecen óptimos resultados en la ganancia de movimiento articular y minimizan el riesgo de sobreestresar las estructuras intraarticulares. Por lo tanto, un diagnóstico de hipomovilidad articular con una sensación terminal firme que indique la correcta aplicación de una manipulación translatoria evita desencadenar una reacción adversa a nuestro tratamiento. En la columna cervical, y en especial sobre la columna cervical superior, esta situación se magnifica, ya que las reacciones adversas pueden ser incluso fatales para el paciente. Conclusión. La eficacia y seguridad de la manipulación cervical depende de una apropiada indicación, un diagnóstico preciso, la elección adecuada del tipo de manipulación y su correcta aplicación

Joint manipulation is a physiotherapy technique with certain "status" inside our therapeutical tools due to the promise of good results in a very brief period of time, the halo of mysticism that surrounds it, the fear produced by side effects during its application and the type of impulse to be developed. Although literature almost always refers to only one kind of manipulation, the rotatoric one, manipulation can be made through translatoric movements of traction and gliding that offer optimal results in increasing joint movement and minimize the risk of excessive stress on the intraarticular structures. Therefore, a diagnosis of joint hypomobility with a firm end feel suitable for the indication of a correct application of translatoric manipulation avoids eliciting an adverse reaction to our treatment. In the cervical spine and specially in the upper cervical spine, this situation is magnified because adverse reactions in this region could be fatal for the patient. Conclusion. The effectiveness and security of cervical manipulation depends on an appropriate indication, a precise diagnosis, and adequate election of the type of manipulation and its correct application

Factores pronosticos del melanoma. / Prognostic factors of melanoma

Se revisaron los factores pronosticos del melanoma en 69 casos controlados a largo, plazo encontrando que los factores que influyen sobre la supervivencia son diametro de la lesion, nivel de Clark, espesor tumoral, presencia de satelites, infiltracion linfatica o vascular y sobre todo, presencia de ganglios metastaticos, por lo que cuando existen estos factores deben utilizarse medidas terapeuticas mas agresivas. La mayor parte de los casos estudiados se encontraron en estados avanzados, a pesar de lo cual se obtuvo supervivencia a 5 anos del 51 por ciento

Carcinoide del apendice cecal. / Carcinoid tumor of the cecal appendix

Se revisaron 8,950 apendices cecales y se encontraron 19 carcinoides (0,21%).La neoplasia predomino en hombres, 11:8. La edad promedio de los pacientes fue de 30.8 anos El diagnostico clinico mas comun fue apendicitis aguga (73.6%); ningun caso se diagnostico clinicamente.Solamente 7 casos fueron identificados macroscopicamente. El tamano de la lesion vario de 0.1 a 1.8 cm.de diametro. Catorce casos correspondieron a la variedad clasica o comun de carcinoide, 4 a la variante de adenocarcinoide tubular y uno fue una forma mixta. Las reacciones histoquimicas evidenciaron dos tipos de carcinoide: el carcinoide clasico, positivo para celulas argirofilas y argentafines; el adenocarcinoide que tuvo afinidad para las tinciones de mucopolisacaridos neutros y acidos y la fraccion secretora de la inmunoglobulina A. El 89.4% de los casos mostro alteraciones histopatologicas agregadas al carcinoide; la mas comun fue apendicitis aguda (52.6%). En 5 casos (26.5%) la neoplasia paso inadvertida para el patologo que estudio el especimen. Se sugiere un minucioso examen del apendice cecal, se aconseja practicar secciones longitudinales y el estudio histologico de toda una mitad y de cualquier zona sospechosa