High-Intensity Forward-Backward Plyometrics After the Warm-Up Entail Better Sprint and Change-of-Direction Performance Than Low-Intensity Side-to-Side Plyometrics.

This study aimed to determine the acute effects of high-intensity forward-backward and low-intensity side-to-side plyometric jumps performed following the warm-up on sprint (5, 10, and 15 m) and change-of-direction (COD) (T-half test and repeated T-half tests) performance in youth volleyball players. After a familiarization week, 30 male volleyball players (age = 12.04 ± 1.03 years) performed three randomized conditions (no-plyometrics, high-intensity plyometrics, and low-intensity plyometrics) in three sessions. In a within-subject design, three sets of six repetitions of forward-backward 30-cm hurdle jumps (high-intensity) and side-to-side 20-cm hurdle jumps (low-intensity) were completed. Sprint and COD were tested after each of the conditions with a 2-min rest. A significant effect of the plyometric condition was observed on sprint (p < .001, ηp2 range: .56-.70) and COD (p < .01, ηp2=.24), but not on repeated COD. More specifically, the high-intensity plyometric condition exhibited significantly better results compared with the low-intensity plyometric (Cohen's d range: 0.73-1.21) and control conditions (Cohen's d range: 0.91-2.21). Due to the importance of speed and COD in volleyball, these results suggest that young volleyball players may benefit from high-intensity forward-backward plyometric protocols following the warm-up to improve subsequent performance.

Comparative Study of the Long-Term Impact of the COVID-19 Pandemic on Mental Health and Nutritional Practices Among International Elite and Sub-Elite Athletes: A Sample of 1420 Participants from 14 Countries.

BACKGROUND: Although several studies have shown that the Coronavirus Disease 2019 (COVID-19) lockdown has had negative impacts on mental health and eating behaviors among the general population and athletes, few studies have examined the long-term effects on elite and sub-elite athletes. The present study aimed to investigate the long-term impact of COVID-19 lockdown on mental health and eating behaviors in elite versus sub-elite athletes two years into the pandemic. A cross-sectional comparative study was conducted between March and April 2022, involving athletes from 14 countries, using a convenient non-probabilistic and snowball sampling method. A total of 1420 athletes (24.5 ± 7.9 years old, 569 elites, 35% women, and 851 sub-elites, 45% women) completed an online survey-based questionnaire. The questionnaire included a sociodemographic survey, information about the COVID-19 pandemic, the Depression, Anxiety and Stress Scale-21 Items (DASS-21) for mental health assessment, and the Rapid Eating Assessment for Participants (REAP-S) for assessing eating behavior. RESULTS: The results showed that compared to sub-elite athletes, elite athletes had lower scores on the DASS-21 (p = .001) and its subscales of depression (p = .003), anxiety (p = .007), and stress (p < .001), as well as a lower REAP-S score indicating lower diet quality (p = .013). CONCLUSION: In conclusion, two years into the pandemic, elite athletes were likelier to have better mental health profiles than sub-elite athletes but surprisingly had lower diet quality.

Fournier's Gangrene: validation of the severity index.

INTRODUCTION: Fournier's gangrene is a serious infection and is considered a major emergency. A complete assessment of the severity factors using a severity score is essential and makes it possible to adapt the therapeutic management. AIM: Validate Fournier's Gangrene Severity Index and evaluate its benefits in the initial assessment of disease severity. METHODS: This is a retrospective, monocentric study which gathered all the cases of perineal gangrene that were managed in General Surgery Department of Habib Bougatfa Hospital in Bizerte over a period of 8 years. The primary endpoint in our study was mortality. RESULTS: Thirty-five cases of Fournier's gangrene were collected. The average age of our patients was 46 years. Mortality rate was 23%. We calculated the Fournier's Gangrene Severity Index for 22 patients. There was a significant difference in the average Fournier's Gangrene Severity Index score between the group of surviving patients (3.75) and the group of deceased patients (12.63) (p 9.5 (sensitivity 87.5%, specificity 100%), we noted that the mortality rate was significantly higher in the group with a score> 10 (100%) than in the group with a score ≤ 9 (6%) (p.

A giant renal hydatid cyst with pleural extension and epiploic localization management: A case report.

Hydatidosis is a rare parasitic disease that is endemic in many countries of the Mediterranean basin caused by the larval form of Echinococcus Granulosus. Among unusual localizations, renal involvement is rare, especially extension to the pleural cavity. Herein, we report a rare case of 75-year-old woman with giant renal hydatid cyst complicated by pleural extension. The patient was successfully treated with a median phreno-laparotomy.The renal hydatid cyst was completely emptied with resection of the epiploic hydatid cyst.The diaphragmatic breach was closed after resection of the necrotic margins. With 1 month albendazole therapy.

Gayet-Wernicke's encephalopathy complicating prolonged parenteral nutrition in patient treated for colonic cancer - a case report.

BACKGROUND: Gayet-Wernicke's encephalopathy (GWE) is a neurological pathology caused by a Thiamine deficiency. While it is most often related to chronic alcoholism, GWE can occur in any situation that results in thiamine deficiency. It is a fairly common pathology that is frequently underdiagnosed and therefore under-treated, and is associated with a high mortality and morbidity rate. In the absence of pathognomonic signs, the diagnosis of GWE relies on a range of clinical, biological and radiological assessments. GWE is considered a medical emergency. We present a case of Gayet-Wernicke's Encephalopathy resulting from complete parenteral nutrition in an undernourished North African male operated for a left colon tumor. Through this report, our aim was to put the light on this often underknown disease and to remind the interest of thinking about this pathology in patients at risk of undernourishment especially in oncology. CASE PRESENTATION: A 66-year-old North African male with no personal or family history was operated for a sigmoid colon tumor. He was put on exclusive parenteral nutrition on day thirteen post-operatively and presented with a GWE on day sixteen post-operatively. The patient was treated with intravenous vitamin B1 on day eighteen post-operatively and deceased on day twenty-four post-operatively. CONCLUSIONS: Although most often associated with chronic alcoholism, GWE occurs in any situation where there is an increased energy demand or decreased nutritional intake especially in oncology. GWE is common but under-diagnosed and remains lethal if not treated urgently, hence the importance of prophylactic treatment.

Right Colon Clear Cell Carcinoma of Müllerian Type.

Clear cell carcinoma (CCC) is usually seen in tissues originating from the paramesonephric (Müllerian) ducts such as the kidneys, the ovaries, the cervix and the vagina. The pathogenesis has not yet been elucidated. The diagnostic hallmark is the clear cytoplasm. Primitive CCC of the colon is a very rare entity. There are two types of CCC of the colon; the intestinal type and the Müllerien type. The differential diagnosis arises mainly with secondary metastases of renal or ovarian origin. Immunohistochemistry allows retaining the primitive character. The treatment is not yet consensual. It depends on the type of tumor and its stage. The treatment is based on surgery and possibly chemotherapy. We report the case of a 75-year-old female patient who underwent surgery for a tumor of the ascending colon. Microscopic examination concluded an extensively necrotic carcinomatous growth which infiltrated all the layers of the intestinal wall and the peritoneum. The tumor was made of clusters and spans of clear cells which were separated by thin conjunctivo-vascular septa. The tumor cells were round to polygonal with a clear, optically empty, pseudo-vegetative (physaliferous) cytoplasm. Immunohistochemistry study showed a positive staining with CK7 and a negative staining with CK20, CDX2, PAX8, P63, CD10, chromogranin, and synaptophysin. We performed a Medical Literature databases (Pubmed and Google Scholar) research. Only forty-two cases were reported in English literature. The main age is 55.7 (25-89). The sex ratio is one, but female cases were younger (52 vs. 61). The rectum is the most involved site. The left colon location is more frequent than the right one. The Müllerian type was found only at the level of the left colon and rectum. There was no CCC in the right colon of Müllerien type. The case we report herein is the first right colon CCC which is positive in CK7 staining.

Case Report: Caecal volvulus management from diagnosis to treatment in a young patient.

Caecal volvulus (CV) is a rare cause of intestinal obstruction, defined by an axial torsion of the caecum, ascending colon, and terminal ileum around the mesenteric vascular pedicles, leading to ischemia and bowel necrosis. A 20-year-old woman, with no significant medical history, was admitted for generalized abdominal pain evolving for three days, along with constipation and abdominal distension, but with no vomiting. Physical examination showed a generalized abdominal tenderness with no rigidity or rebound tenderness, associated with abdominal distension and tympanic upon percussion. Laboratory findings were within normal limits. An abdominal computed tomography scan revealed distension of a loop of the large bowel with its long axis extending from the right lower quadrant to the epigastrium or left upper quadrant. Colonic haustral pattern was absent. An abdominal computed tomography scan showed a rounded focal collection of air-distended bowel with haustral creases in the upper left quadrant. In addition, spiraled loops of the collapsed cecum (giving a whirl sign) were noted, along with low-attenuating fatty mesentery from the twisted bowel. The patient underwent an emergency laparotomy and caecectomy using GEA 80 charges. The patient had no complaints post-operation. CV is a rare cause of bowel obstruction, mainly caused by an exceedingly mobile caecum. Despite its rareness, CV represents the second most common cause of large bowel volvulus, behind sigmoid volvulus. For acute obstruction by CV, it is hard to differentiate it clinically from obstruction of the small bowel; therefore, radiological exams are needed. Surgery is the gold standard treatment for CV. We report a rare case of CV to highlight the rarity of this pathology, specify its diagnostic and therapeutic means, and its clinical and biological evolution.

Acute effects of maximal versus submaximal hurdle jump exercises on measures of balance, reactive strength, vertical jump performance and leg stiffness in youth volleyball players.

Background: Although previous research in pediatric populations has reported performance enhancements following long-term plyometric training, the acute effects of plyometric exercises on measures of balance, vertical jump, reactive strength, and leg stiffness remain unclear. Knowledge on the acute effects of plyometric exercises (i.e., maximal versus submaximal hurdle jumps) help to better plan and program warm-up sessions before training or competition. Objectives: To determine the acute effects of maximal vs. submaximal hurdle jump exercise protocols executed during one training session on balance, vertical jump, reactive strength, and leg stiffness in young volleyball players. Materials and methods: Thirty male youth volleyball players, aged 12-13 years, performed two plyometric exercise protocols in randomized order. In a within-subject design, the protocols were conducted under maximal (MHJ; 3 sets of 6 repetitions of 30-cm hurdle jumps) and submaximal (SHJ; 3 sets of 6 repetitions of 20-cm hurdle jumps) hurdle jump conditions. Pre- and post-exercise, balance was tested in bipedal stance on stable (firm) and unstable surfaces (foam), using two variables [center of pressure surface area (CoP SA) and velocity (CoP V)]. In addition, the reactive strength index (RSI) was assessed during countermovement maximal jumping and leg stiffness during side-to-side submaximal jumping. Testing comprised maximal countermovement jumps (CMJ). Results: Significant time-by-condition interactions were found for CoP SA firm (p < .0001; d = 0.80), CoP SA foam (p < .0001; d = 0.82), CoP V firm (p < .0001; d = 0.85), and CoP V foam (p < .0001; d = 0.83). Post-hoc analyses showed significant improvements for all balance variables from pretest to posttest for MHJ but not SHJ. All power tests displayed significant time-by-group interactions for countermovement jumps (p < .05; d = 0.42), RSI (p < .0001; d = 1.58), and leg stiffness (p < .001; d = 0.78). Post-hoc analyses showed significant pre-post CMJ (p < .001, d = 1.95) and RSI (p < .001, d = 5.12) improvements for MHJ but not SHJ. SHJ showed larger pre-post improvements compared with MHJ for leg stiffness (p < .001; d = 3.09). Conclusion: While the MHJ protocol is more effective to induce acute performance improvements in balance, reactive strength index, and vertical jump performance, SHJ has a greater effect on leg stiffness. Due to the importance of postural control and muscle strength/power for overall competitive performance in volleyball, these results suggest that young volleyball players should implement dynamic plyometric protocols involving maximal and submaximal hurdle jump exercises during warm-up to improve subsequent balance performance and muscle strength/power.

Leg muscle power in 12-year-old black and white Tunisian football players.

This study examined leg muscle power of young male Tunisian black and white football players and extended the analysis to determine whether there is a relationship between cycling peak power output (PPO) and some field tests. A total of 113 children (white group (WG) = n = 56; black group (BG) = n = 57) participated in this investigation. Anthropometric data included age, body mass (BM), height, leg length (LL), body mass index (BMI), and leg muscle volume (LMV). Cycling PPO was measured including a force-velocity test. Peak power output (PPO; W and W/kg), Fopt (optimal braking force), and Vopt (optimal velocity) were significantly higher in the WG compared with the BG (p < 0.05). However, jump and sprint performances of the BG were significantly higher than the WG (p < 0.05). Multiple stepwise regression with anthropometric variables and the extrapolated values of the force-velocity test as explanatory factors showed that 33% of the variance of PPO of BG was explained by qualitative factors that may be related to cycling skill, muscle composition, and socioeconomic and training status.

Relationships of the 5-Jump Test (5JT) Performance of Youth Players With Volleyball Specific' Laboratory Tests for Explosive Power.

Volleyball involves movements with and/or without horizontal approaches (i.e., spike jumps, jump setting, blocking). The 5-jump test (5JT) was suggested to assess lower limb explosive power of athletes competing in some disciplines (e.g., soccer, judo, running). It appears that no previous study has investigated the 5JT performance components in volleyball players. This study aimed to test the relationship between 5JT performance and two specific laboratory tests for explosive power (i.e., countermovement jump [CMJ] and squat jump [SJ]). Forty volleyball players (boys, mean age: 12.4 ± 0.8 years) were tested for 5JT, CMJ, and SJ tests. 5JT performance was expressed in absolute terms (m), and relative to leg length (5JTLL) and body mass (5JTBM). The SJ and CMJ tests were evaluated using the optojump photoelectric cells and the following data were collected: peak power (Pp) of jump (W, W.kg-0.67), peak jumping force (Fpeak, N), peak jumping velocity (Vpeak, m/s), peak heights of CMJ and SJ (CMJH and SJH, respectively, cm). Only significant (p < .05) Pearson product-moment correlations (r) > 0.30 were considered. 5JT performance was significantly correlated with SJ, Vpeak (r = 0.90), SJH (r = 0.88), Pp [W.kg-0.67 (r = 0.86), W (r = 0.72)], Fpeak (r = 0.45); and CMJ, Vpeak (r = 0.82), CMJH (r = 0.80), Pp [W.kg-0.67 (r = 0.89), W (r = 0.85)], Fpeak (r = 0.73). 5JTLL values were significantly related to SJ, Pp [W (r = 0.81), W.kg-0.67 (r = 0.74)], Vpeak (r = 0.82); and CMJ, Pp [W (r = 0.73), W.kg-0.67 (r = 0.84)], Vpeak (r = 0.75), Fpeak (r = 0.67)]. 5JTBM values were significantly related to SJ, Pp (W, r = -0.43). To conclude, in youth volleyball players, the 5JT may be viewed as an explosive strength diagnostic instrument under field circumstances.

[Therapeutic factors affecting the healing process in patients with gangrene of the perineum]. / Facteurs thérapeutiques affectant la cicatrisation au cours des gangrènes du périnée.

Fournier gangrene is a rare and severe necrotizing fasciitis. It is burdened with high morbi-mortality, requiring early and massive medical and surgical management. Initial treatment is based on patient's resuscitation associated with surgical debridement. Subsequently, the main challenge is the healing process and its possible sequelae. Several therapeutic approaches are currently available to improve and accelerate the healing process. We conducted a retrospective study of 20 cases. The median age of our patients was 56 years. The study included 16 men and 7 women. Comorbidity was present in 15 patients. Antibiotic therapy was administered in all cases, with a median duration of 15 days. All patients underwent surgery. Iterative reviews were necessary in all patients, who needed, on average, 3 dressing changes. Colostomy was performed in 6 cases. Hyperbaric oxygen therapy was performed in 4 cases. Vacuum assisted closure was performed in 1 case. Soft tissue coverage was necessary in 2 cases. The mean duration of healing was 15 days with oxygen therapy versus 24 days in the absence of this treatment. The mean duration of hospitalization was 20 days. Four patients died. Healing process without sequelae is a therapeutic challenge. Despite the addition of new therapeutic approaches, outcomes are not satisfactory. However, multidisciplinary approach associated with oxygen therapy and vacuum assisted closure might improve patients outcomes.

Predictive factors of morbidity after surgical treatment of hydatid cyst of the liver.

BACKGROUND AND STUDY AIMS: Hepatic hydatid cyst is a major health problem in endemic areas. Surgery is still the best choice for treatment of the hydatid cyst of the liver. However, it is still associated with high mortality and morbidity. The aim of the study was to evaluate the predictive factors for specific morbidity after conservative surgical treatment of the hydatid cyst of the liver. PATIENTS AND METHODS: A total of 120 patients who underwent conservative surgical treatment between 2001 and 2011 were evaluated retrospectively. RESULTS: Of the 120 patients, 64 were female subjects and 56 male subjects; the median age was 33 years (14-83 years). The mortality rate was 0%. The overall morbidity rate was 26.6%. The specific morbidity rate was 16.6%. The major specific complications were infection of the residual cavity in 10 cases and an external biliary fistula in eight cases. The predictive factors of morbidity in univariate analysis were bilious cyst content, location of the cyst in the hepatic dome, and size >10 cm. After multivariate analysis, only the size of the cyst was an independent predictive factor of morbidity. CONCLUSION: The size of the cyst was the significant predictor of morbidity of conservative surgery for liver hydatid cyst.