Game Demands of Seven-A-Side Soccer in Young Players.

Barbero-Alvarez, JC, Gómez-López, M, Castagna, C, Barbero-Alvarez, V, Romero, DV, Blanchfield, AW, and Nakamura, FY. Game demands of seven-a-side soccer in young players. J Strength Cond Res 31(7): 1771-1779, 2017-The aim of this study was to examine the activity patterns and physiological demands of 7-a-side youth soccer matches across 2 chronological age categories (U12 and U14). Twenty-two soccer players of a national youth soccer academy were investigated. Players of each age category performed 2 training matches (2 × 25 minutes) and were monitored by global positioning system and heart rate monitor units. Players of both categories covered similar total distance (5,348 ± 307 m), at similar mean heart rate values (86 ± 4% of maximum). However, the number of high-intensity runs (82.5 ± 17.4 vs. 69.7 ± 15.2) and total distance covered during sprints (264 ± 207 vs. 128 ± 74 m) were significantly (p ≤ 0.05) higher in U14 compared with U12. The results suggest a highly demanding nature of 7-a-side soccer for skilled players, with physical maturity possibly influencing the match-related high-intensity performance at these ages.

Iron status markers are only transiently affected by a football game.

We examined the temporal variation of iron's status markers during a 60 h period following a football game. Thirty-four male football players were randomly assigned to a control group (CG, N = 14, participated only in measurements and training) or an experimental group (EG, N = 20, took part in a football game one week after the completion of the competitive season). All participants trained regularly for two consecutive days after the game. Training and game load was monitored with high time-resolution global positioning system (GPS) devices. Blood samples were collected and muscle damage markers and repeated sprint ability (RSA) were assessed pre-game and at 2 h, 12 h 36 h and 60 h post-game. No changes were noted in CG. Iron concentration decreased (P < 0.05) 2 h post-game and normalised thereafter whereas total iron binding capacity increased (P < 0.05) 12-60 h of recovery (P < 0.05). Erythrocytes, haemoglobin (HGB) concentration, plasma volume, haematocrit, mean cell volume, mean cell HGB, mean cell HGB concentration, red cell width-SD, red cell width-CV, ferritin concentration and transferrin saturation remained unaltered during the intervention period. Creatine kinase activity and muscle soreness increased (P < 0.05) throughout recovery in EG. RSA declined (P < 0.05) until 36 h of recovery and normalised thereafter. Our data demonstrate that iron status markers are only transiently affected by a football game.

Plyometrics' trainability in preadolescent soccer athletes.

Plyometric training (PT) is a widely used method to improve muscle ability to generate explosive power. This study aimed to determine whether preadolescent boys exhibit plyometric trainability or not. Forty-five children were randomly assigned to either a control (CG, N = 21, 10.6 ± 0.5 years; participated only in regular soccer practice) or a plyometric training group (PTG, N = 24, 10.6 ± 0.6 years; participated in regular soccer practice plus a plyometric exercise protocol). Both groups trained for 12 weeks during the in-season period. The PT exercises (forward hopping, lateral hopping, shuffles, skipping, ladder drills, skipping, box jumps, low-intensity depth jumps) were performed twice a week. Preadolescence was verified by measuring Tanner stages, bone age, and serum testosterone. Speed (0-10, 10-20, 20-30 m), leg muscle power (static jumping, countermovement jumping, depth jumping [DJ], standing long jump [SLJ], multiple 5-bound hopping [MB5]), leg strength (10 repetition maximum), anaerobic power (Wingate testing), and soccer-specific performance (agility, kicking distance) were measured at baseline, midtraining, and posttraining. The CG caused only a modest (1.2-1.8%) increase in speed posttraining. The PTG induced a marked (p < 0.05) improvement in all speed tests (1.9-3.1% at midtraining and 3-5% at posttraining) and vertical jump tests (10-18.5% at midtraining and 16-23% at posttraining), SLJ (2.6% at midtraining and 4.2% at posttraining), MB5 (14.6% at midtraining and 23% at posttraining), leg strength (15% at midtraining and 28% at posttraining), agility (5% at midtraining and 23% at posttraining), and kicking distance (13.6% at midtraining and 22.5% at posttraining). Anaerobic power remained unaffected in both groups. These data indicate that (a) prepubertal boys exhibit considerable plyometric trainability, and (b) when soccer practice is supplemented with a PT protocol, it leads to greater performance gains.

Projected changes in atmospheric moisture transport contributions associated with climate warming in the North Atlantic.

Global warming and associated changes in atmospheric circulation patterns are expected to alter the hydrological cycle, including the intensity and position of moisture sources. This study presents predicted changes for the middle and end of the 21st century under the SSP5-8.5 scenario for two important extratropical moisture sources: the North Atlantic Ocean (NATL) and Mediterranean Sea (MED). Changes over the Iberian Peninsula-considered as a strategic moisture sink for its location-are also studied in detail. By the end of the century, moisture from the NATL will increase precipitation over eastern North America in winter and autumn and on the British Isles in winter. Moisture from the MED will increase precipitation over the southern and western portions of the Mediterranean continental area. Precipitation associated with the MED moisture source will decrease mainly over eastern Europe, while that associated with the NATL will decrease over western Europe and Africa. Precipitation recycling on the Iberian Peninsula will increase in all seasons except summer for mid-century. Climate change, as simulated by CESM2 thus modifies atmospheric moisture transport, affecting regional hydrological cycles.

Uncertainty in surface wind speed projections over the Iberian Peninsula: CMIP6 GCMs versus a WRF-RCM.

This study assessed the projected near-surface wind speed (SWS) changes and variability over the Iberian Peninsula for the 21st century. Here, we compared Coupled Model Intercomparison Project Phase 6 global climate models (GCMs) with a higher spatial resolution regional climate model (RCM; ∼20 km), known as WRF-CESM2, which was created by a dynamic downscaling of the Community Earth System Model version 2 (CESM2) using the Weather Research and Forecasting (WRF) model. Our analysis found that the GCMs tended to overestimate observed SWS for 1985-2014, while the higher spatial resolution of the WRF-CESM2 did not improve the accuracy and underestimated the SWS magnitude. GCMs project a decline of SWS under high shared socioeconomic pathways (SSPs) greenhouse concentrations, such as SSP370 and SSP585, while an interdecadal oscillation appears in SSP126 and SSP245 for the end of the century. The WRF-CESM2 under SSP585 predicts the opposite increasing SWS. Our results suggest that 21st-century projections of SWS are uncertain even for regionalized products and should be taken with caution.

Dataset of outer tropical cyclone size from a radial wind profile.

Pérez-Alarcón et al. [1] developed a comparative climatology of the outer radius of tropical cyclones (TCs) from several radial wind profiles. They showed that the Willoughby et al. (2006) (W06) profile can be used to reproduce the TC tangential wind speed; thus, this profile is skilful for estimating the TC outer radius. Here, we present a database of TC sizes estimated from the W06 radial wind profile in each cyclogenetic basin worldwide. The database incorporates the critical wind radii, where the tangential wind speed is approximately 17.5 ms-1 (R34), 26 ms-1 (R50), 33 ms-1 (R64), and 51 ms-1 (R100), estimated by the W06 profile. The database has a comma-delimited text format with six-hour information on the location, maximum wind speed, central pressure, and the different TC metrics mentioned above. This database has a similar structure to that of the Atlantic Hurricane Database (HURDAT2) of the National Hurricane Center. The database presented here is applicable to studies on TC storm surge risks as well as to the determination of the sources and sinks of atmospheric moisture related to tropical cyclogenesis processes.

Idiopathic Acquired Hemophilia A, a Rare Cause of Bleeding: A Case Report and Literature Review.

BACKGROUND Acquired hemophilia is a bleeding disorder mediated by an autoimmune process, in which antibodies against clotting factors are developed. This is a rarely suspected complex condition in which the initial manifestations are spontaneous bleeding in the skin, soft tissues, and mucosa in patients with no known history of bleeding disorders. Most of the cases are idiopathic (50%), but it can be associated with autoimmune diseases, malignancy, pregnancy, and medications. The most frequent type is mediated by inhibitors against factor VIII, followed by coagulation factor IX and XI. It is a disease with high morbidity and mortality rates without adequate treatment. Diagnosis is based on the detection of low concentrations of clotting factors and the presence of an inhibitor. CASE REPORT We present 2 cases of patients with spontaneous bleeding in whom the diagnosis of idiopathic acquired hemophilia A was made, an extensive malignancy study was performed that was negative, and the presence of autoimmunity markers (positive antinuclear antibodies (ANA)) was observed, without any another sign of autoimmune disease. They received immunosuppressive therapy with bleeding control and inhibitor eradication. CONCLUSIONS Acquired hemophilia A is a rare but potentially lethal disease, representing a medical challenge from its diagnosis to its treatment. An early recognition and treatment are fundamental because delays are associated with adverse outcomes. Optimal management includes the workup and treatment for an underlying disease, use of "bypass" agents when active bleeding presents, and inhibitor titer eradication through immunosuppressants drugs. With the present cases, we highlight the importance of considering acquired hemophilia A in older patients with similar symptoms, to achieve early diagnosis and treatment.

Pelvic Renal Ectopia: Unusual Position Abnormality.

Pelvic renal ectopia is a congenital anomaly secondary to poor renal migration to the lower back. Usually, these pathologies are of asymptomatic course, therefore its finding is usually fortuitous during radiological examinations for other causes or in work-up of the infrequent symptomatic cases characterized by the occurrence of recurrent infections or symptoms of obstructive uropathy. The objective of this report is to present a case of a 37-year-old female with the unusual manifestation of left pelvic renal ectopia. She was intervened for acute lithiasic cholecystitis, and radiologic techniques diagnosed left pelvic renal ectopia. An updated review of the literature is performed. Despite the anomaly, the patient's renal function tests were normal, so only cholecystectomy was performed without complications.

Pharmacokinetics and Pharmacodynamics of Cefepime in Adults with Hematological Malignancies and Febrile Neutropenia after Chemotherapy.

Patients with chemotherapy-induced febrile neutropenia (CIFN) may have changes in the pharmacokinetics (PK) compared to patients without malignancies or neutropenia. Those changes in antibiotic PK could lead to negative outcomes for patients if the therapy is not adequately adjusted to this. In this, open-label, non-randomized, prospective, observational, and descriptive study, a PK model of cefepime was developed for patients with hematological neoplasms and post-chemotherapy febrile neutropenia. This study was conducted at a cancer referral center, and study participants were receiving 2 g IV doses of cefepime every 8 h as 30-min infusions. Cefepime PK was well described by a two compartment model with a clearance dependent on a serum creatinine level. Using Monte Carlo simulations, it was shown that continuous infusions of 6g q24h could have a good achievement of PK/PD targets for MIC levels below the resistance cut-off point of Enterobacteriaceae. According to the simulations, it is unnecessary to increase the daily dose of cefepime (above 6 g daily) to increase the probability of target attainment (PTA). Cumulative fraction of response (CFR) using interment dosing was suboptimal for empirical therapy regimens against K. pneumoniae and P. aeruginosa, and continuous infusions could be used in this setting to maximize exposure. Patients with high serum creatinine levels were more likely to achieve predefined PK/PD targets than patients with low levels.

Relationship between endurance field tests and match performance in young soccer players.

The purpose of this study was to examine the relationship between popular endurance field tests and physical match performance in elite male youth soccer players. Eighteen young male soccer players (age 14.4 ± 0.1 years, height 1.67 ± 4.8 cm, body mass 53.6 ± 1.8 kg) were randomly chosen among a population of elite-level soccer players. Players were observed during international championship games of the corresponding age categories and randomly submitted to the level 1 of the Yo-Yo intermittent recovery test (Yo-Yo IR1), the Multistage Fitness Test (MSFT), and the Hoff test on separate occasions. Physical and physiological match demands were assessed using Global Positioning System technology and short-range telemetry (GPS Elite, Canberra, Australia), respectively. Players covered 6,087 ± 582 m (5,098-7,019 m) of which 15% (930 ± 362 m; 442-1,513) were performed as a high-intensity activity. During the first and second halves, players attained 86.8 ± 6.5 and 85.8 ± 5.8% of maximum heart rate (HRmax; p = 0.17) with peak HRs of 100 ± 2 and 99.4 ± 3.2% of HRmax, respectively. Players' Yo-Yo IR1 and MSFT performance were significantly related (r = 0.62-0.76) to a number of match physical activities. However, the Hoff test was only significantly related with sprint distance (r = 0.70, p = 0.04). The Yo-Yo IR1 showed a very large association with MSFT performance (r = 0.89, p < 0.0001). The results of this study showed that the Yo-Yo IR1 and MSFT may be regarded as valuable tests to assess match fitness and subsequently guide training prescription in youth soccer players. The very strong relationship between Yo-Yo IR1 and MSFT suggests their use according to the period of the season and the aerobic fitness level of the players. Because of the association of the Yo-Yo IR1 and MSFT with match physical performances, these tests should be considered in talent selection and development of players.

Immunoglobulin A Nephropathy With Extracapillary Proliferation and Positive Anti-Neutrophil Cytoplasmic Antibodies: A Rare Cause of Dual Glomerulonephritis.

The coexistence of immunoglobulin A (IgA) nephropathy and associated pauci-immune anti-neutrophil cytoplasmic antibody (ANCA) glomerulonephritis represents a rare concurrence of two common forms of glomerulonephritis; the pathogenesis, treatment, and prognosis of this dual glomerulopathy are not well described. This illustrative case can present this association in an HIV-positive patient and how despite the coexistence of these two entities, the patient had control of his kidney disease with low doses of steroids, contrary to the different reports of cases in the literature in which the treatment is often more aggressive. In this case report, we review the literature on this dual glomerulonephritis and confront clinical and treatment aspects regarding the different clinical cases reported in the databases.

Paraneoplastic Hypoglycemia in Hepatocarcinoma: Case Report and Literature Review.

Hypoglycemia is a common medical emergency in the context of insulin treatment in diabetic patients and oral hypoglycemic agents such as sulfonylureas. In anecdotal cases, hypoglycemia is associated with non-islet cell tumor-induced hypoglycemia (NICTH). In hepatocellular carcinoma (HCC), it has been reported in 4-27% of patients, and it is associated with poor prognosis. We present a case report of a patient with hypoglycemia associated with HCC secondary to chronic hepatitis B virus infection without response to treatment with glucagon, steroids, octreotide, and embolizations, who required parenteral nutrition at home. Even though hypoglycemia associated with HCC is a recognized entity, there is not sufficient evidence in its treatment and prevention. The article aims to review the literature on prevention and therapeutic options.

Varicella-Zoster Virus Meningitis and Encephalitis: An Understated Cause of Central Nervous System Infections.

Background Varicella-zoster virus (VZV) and herpes zoster cause infections of the central nervous system (CNS) manifesting as meningitis or encephalitis. As compared to enterovirus (EV) and herpes simplex virus 1 (HSV-1) and 2 (HSV-2), it is not often tested in CNS infections due to VZV and herpes zoster. There is a certain tendency to think that the findings in the cerebrospinal fluid in infections of the CNS by viruses are comparable among themselves. The exact proportion of patients with VZV primary and reactivation infection who present with lesions prior to or concomitant to its involvement in the CNS is unknown. It is also not known about the risk factors that lead to the reactivation of VZV and CNS involvement. Objective To describe the clinical characteristics and laboratory results of patients with a positive VZV polymerase chain reaction (PCR) and neurological signs and symptoms. Methods A retrospective and descriptive study was performed at the Hospital Universitario de la Pontificia Universidad Católica de Chile (Hospital Clínico UC CHRISTUS) from September 2012 to July 2014. The following parameters were recorded: neurological signs and symptoms, PCR for VZV in cerebrospinal fluid (CSF), comorbidities, personal medical history, cutaneous lesions, CSF characteristics, CNS imaging, electroencephalography (EEG), treatment, mortality, and neurological sequelae. Adult patients with meningitis, encephalitis, or meningoencephalitis due to VZV diagnosed with PCR were included. Results Out of 70 CSF samples analyzed in the previously mentioned period, 21 cases were VZV positive, 16 cases that had clinical information available were included. The mean age with VZV CNS reactivation was 47 years (range 19-80 years). Five patients (31.25%) were immunocompromised: three had human immunodeficiency virus (HIV), one had kidney transplantation, and one had primary immunodeficiency. Clinical presentation was meningitis in 11 patients (68.75%) and encephalitis in five patients (31.25%). Pleocytosis in CSF was observed in all the samples. The five immunocompromised patients had cutaneous lesions. All patients received antiviral treatment. Therapy duration was from 10 up to 21 days. The clinical course was positive in most patients and the mean hospitalization time was 15 days (range 5-60 days). No mortality was observed. Conclusions VZV is a worldwide virus and a common cause of CNS infection. The rising incidence is probably due to a better diagnostic method and a frequent clinical suspicion even in the absence of cutaneous lesions, except in immunocompromised cases, as it was observed in the present study. CNS infection presented as a wide spectrum of clinical manifestations with possible neurological sequelae. There was a reduction in neurological morbidity with antiviral therapy. Nonetheless, both the incidence and the morbidity of CNS VZV infection are expected to be diminished by varicella and herpes zoster vaccination. Additionally, there was no increase in mortality in these patients.

Recovery kinetics of knee flexor and extensor strength after a football match.

We examined the temporal changes of isokinetic strength performance of knee flexor (KF) and extensor (KE) strength after a football match. Players were randomly assigned to a control (N = 14, participated only in measurements and practices) or an experimental group (N = 20, participated also in a football match). Participants trained daily during the two days after the match. Match and training overload was monitored with GPS devices. Venous blood was sampled and muscle damage was assessed pre-match, post-match and at 12 h, 36 h and 60 h post-match. Isometric strength as well as eccentric and concentric peak torque of knee flexors and extensors in both limbs (dominant and non-dominant) were measured on an isokinetic dynamometer at baseline and at 12 h, 36 h and 60 h after the match. Functional (KFecc/KEcon) and conventional (KFcon/KEcon) ratios were then calculated. Only eccentric peak torque of knee flexors declined at 60 h after the match in the control group. In the experimental group: a) isometric strength of knee extensors and knee flexors declined (P<0.05) at 12 h (both limbs) and 36 h (dominant limb only), b) eccentric and concentric peak torque of knee extensors and flexors declined (P<0.05) in both limbs for 36 h at 60°/s and for 60 h at 180°/s with eccentric peak torque of knee flexors demonstrating a greater (P<0.05) reduction than concentric peak torque, c) strength deterioration was greater (P<0.05) at 180°/s and in dominant limb, d) the functional ratio was more sensitive to match-induced fatigue demonstrating a more prolonged decline. Discriminant and regression analysis revealed that strength deterioration and recovery may be related to the amount of eccentric actions performed during the match and athletes' football-specific conditioning. Our data suggest that recovery kinetics of knee flexor and extensor strength after a football match demonstrate strength, limb and velocity specificity and may depend on match physical overload and players' physical conditioning level.

Pharmacokinetics of piperacillin/tazobactam in cancer patients with hematological malignancies and febrile neutropenia after chemotherapy.

INTRODUCTION: Patients with febrile neutropenia (FN) exhibit changes in extracellular fluid that may alter the plasma concentrations of beta-lactams and result in therapeutic failure or toxicity. We evaluated the pharmacokinetics of piperacillin/tazobactam in patients with hematological malignancies and FN after receiving chemotherapy at a primary public cancer center. METHODS: This was an open, nonrandomized, observational, descriptive, and prospective study. Samples from 15 patients with hematological malignancies and FN were evaluated after the administration of chemotherapy. Five blood samples were taken from each patient when the antibiotic level was at steady-state 10, 60, 120, 180, and 350 min after each dose. Antibiotic concentrations were measured using gel diffusion with Bacillus subtilis. All study participants provided written informed consent. RESULTS: We investigated the pharmacokinetics of piperacillin in 14 patients between the ages of 18 years and 59 years and with a mean absolute neutrophil count of 208 cells per mm³ (standard deviation (SD) ± 603.2). The following pharmacokinetic measurements were obtained: maximum concentration, 94.1-1133 mg/L; minimum concentration, 0.47-37.65 mg/L; volume of distribution, 0.08-0.65 L/kg (mean, 0.34 L/kg); drug clearance (CL), 4.42-27.25 L/h (mean, 9.93 L/h); half-life (t(1/2)), 0.55-2.65 h (mean, 1.38 h); and area under the curve, 115.12-827.16 mg · h/L. CONCLUSION: Patients with FN after receiving chemotherapy exhibited significant variations in the pharmacokinetic parameters of piperacillin compared with healthy individuals; specifically, FN patients demonstrated an increase in t1(/2) and decreased CL.

Caffeine-containing energy drink improves physical performance of elite rugby players during a simulated match.

The purpose of this study was to investigate the effectiveness of a caffeine-containing energy drink in enhancing rugby players' physical performance during a simulated match. A second purpose was to determine the urinary caffeine excretion derived from the energy drink intake. In a randomized and counterbalanced order, 26 elite rugby players (mean ± SD for age and body mass, 25 ± 2 y and 93 ± 15 kg) played 2 simulated rugby games (2 × 30 min) 60 min after ingesting (i) 3 mg of caffeine per kilogram of body mass in the form of an energy drink (Fure, ProEnergetics) or (ii) the same drink without caffeine (placebo). During the matches, the individual running distance and the instantaneous speed were measured, and the number of running actions above 20 km·h(-1) (i.e., sprints) were determined, using global positioning system devices. The number of impacts above 5 g during the matches was determined by accelerometry. The ingestion of the energy drink, compared with the placebo, increased the total distance covered during the match (4749 ± 589 vs 5139 ± 475 m, p < 0.05), the running distance covered at more than 20 km·h(-1) (184 ± 38 vs 208 ± 38 m, p < 0.05), and the number of sprints (10 ± 7 vs 12 ± 7, p < 0.05). The ingestion of the energy drink also resulted in a greater overall number of impacts (481 ± 352 vs 641 ± 366, p < 0.05) and a higher postexercise urine caffeine concentration (0.1 ± 0.1 vs 2.4 ± 0.9 µg·mL(-1), p < 0.05). The use of an energy drink with a caffeine dose equivalent to 3 mg·kg(-1) considerably enhanced the movement patterns of rugby players during a simulated match.

The validity and reliability of a global positioning satellite system device to assess speed and repeated sprint ability (RSA) in athletes.

There is a limited understanding of the validity and reliability of commercially available global positioning satellite (GPS) devices for assessing repeated sprint performance in athletes. The aims of this study were to assess the convergent validity and the test-retest reliability of a GPS device for measuring repeated sprint ability test (RSAT) variables. Two groups participated in this study, a group of 21 physical education students (age: 20.2+/-2.3 years, stature: 1.75+/-0.42 m, body mass: 68.0+/-6.8kg) and a second group 14 elite junior soccer players (age: 14.5+/-1.2 years, stature: 1.60+/-0.09 m, body mass: 57.7+/-3.8kg) volunteered to participate in this study. Convergent validity was assessed as the correlation between sprint performance (15 and 30-m) using both timing lights and a portable GPS device during a RSAT (7 x 30-m sprints with 30-s of active recovery). The 7 x 30-m RSAT test-retest reliability using GPS device was assessed in elite junior soccer players repeating the test 1 week apart and expressing reliability as a coefficient of variation. Results showed a strong correlation between peak speed measures with the GPS device and RSAT performance measured with timing lights for the 15-m (r(2)=0.87, p<0.001, N=147) and 30-m (r(2)=0.94, p<0.001, N=147) splits, respectively. There was a low coefficient of variation for summated maximal speed (1.7%) and peak speed (1.2%) during the 7 x 30-m RSAT, but high variation for the percentage decrement score (36.2%). These results provide evidence to support the use of the GPS device as an alternative measure to assess repeated sprint performance but suggest a percentage decrement score is not a reliable measure of RSAT performance.