Body composition is acknowledged as a determinant of athletic health and performance. Its assessment is crucial in evaluating the efficiency of a diet or aspects related to the nutritional status of ...the athlete. Despite the methods traditionally used to assess body composition, bioelectric impedance analysis (BIA) and bioelectric impedance vector analysis (BIVA) have recently gained attention in sports, as well as in a research context. Only until recently have specific regression equations and reference tolerance ellipses for athletes become available, while specific recommendations for measurement procedures still remain scarce. Therefore, the present narrative review summarizes the current literature regarding body composition analysis, with a special focus on BIA and BIVA. The use of specific technologies and sampling frequencies is described, and recommendations for the assessment of body composition in athletes are provided. Additionally, the estimation of body composition parameters (i.e., quantitative analysis) and the interpretation of the raw bioelectrical data (i.e., qualitative analysis) are examined, highlighting the innovations now available in athletes. Lastly, it should be noted that, up until 2020, the use of BIA and BIVA in athletes failed to provide accurate results due to unspecific equations and references; however, new perspectives are now unfolding for researchers and practitioners. In light of this, BIA and especially BIVA can be utilized to monitor the nutritional status and the seasonal changes in body composition in athletes, as well as provide accurate within- and between-athlete comparisons.
The aim of this study was to compare the morbidity of fixation of prosthetic meshes using Tissucol fibrin glue versus staples in laparoscopic transabdominal preperitoneal (TAPP) repair of inguinal ...and femoral hernias.
In patients undergoing laparoscopic hernia repair, fixation of mesh prostheses with staples may affect inguinocrural nerves causing early postoperative neuralgia and chronic neuralgia.
Between June 2003 and February 2005, 197 patients with inguinal or femoral hernia were enrolled in this prospective, randomized study, to assess morbidity following hernia repair with staples (n = 98) or Tissucol (n = 99). The primary outcomes were early postoperative and late neuralgia recorded using a visual analog scale (VAS). The effects of neuralgia on functional status were evaluated using the modified SF-36 questionnaire. Secondary outcomes included complications such as nonspecific pain and recurrence.
Assessments took place at 1, 3, 6, and 12 months, with all patients completing each follow-up visit. Mean VAS scores were significantly lower in the Tissucol group versus the staples group (MANOVA, P < 0.05). Higher scores for the modified SF-36 questionnaire at 1 month were demonstrated in the Tissucol group compared with the staples group (23.2 and 22.6, respectively; P < 0.05). The mean recovery time for normal physical activity was significantly shorter in the Tissucol group compared with the staples group (7.9 vs. 9.1 day, respectively; P < 0.001). One recurrence was seen in the fibrin glue group, which was attributable to a technical error in fixation of the mesh.
The use of Tissucol provides distinct advantages in laparoscopic treatment of inguinal/femoral hernias compared with conventional TAPP, including a lower incidence of postoperative neuralgia and an earlier resumption of physical and social activities.
The aim of this study was to assess how anterior cruciate ligament (ACL) ruptures with subsequent surgery reconstruction impact on the professional career of A1-A2 Italian women's volleyball league ...players.
Using an observational study with a retrospective case-series design for ACL ruptures, 125 teams with 1488 players were monitored. Subjects had to report level, role, injury modality, lower limb injured, laterality, period of the season and age.
A total of 34 ACL ruptures were reported. Thirty-three (97%) were non-contact and 1 (3%) with contact. Twenty-one (61.7%) occurred in landing from a jump attack, 3 (8.8%) in landing from wall jump, 1 (3%) with apparent contact and 9 (26.5%) in other landing conditions. The most injured knee was the left limb (22, 64.7%) respect to the right limb (12, 35.3%). Fourteen (41.2%) ruptures occurred in spikers, 10 (29.4%) in middle blockers, 6 (17.6%) in setters, 3 (8.8%) in liberos and 1 (3%) in opposite hitters. Nine (26.5%) occurred in pre-season period, 16 (47%) in the first round, 4 (11.8%) in the second round, and 5 (14.7%) during play-off. The average age of the first ACL rupture was 23±3 years.
We observed that female volleyball players of A1-A2 Italian volleyball league occurred mostly in a left non-contact ACL rupture during a landing condition and the spikers were the players most at risk. Therefore, it is desirable that coaches teach players variations of landing in order to avoid possible chronic overloading of ACL.
We present here the case of a 75-year-old woman who complained of acute abdominal pain after a diagnostic colonoscopy. Abdominal x-rays demonstrated pneumoperitoneum, whereas chest x-rays showed ...pneumomediastinum and left pneumothorax. A chest drain was placed and subsequently an exploratory laparoscopy was performed, during which air was found in the subserosa of the sigmoid colon and in the mesosigmoid secondary to perforation of a sigmoid diverticulum. The perforation was repaired and a protective loop colostomy was fashioned. The patient was discharged 8 days postoperatively in a good general condition. Although numerous cases of pneumoretroperitoneum and pneumomediastinum secondary to iatrogenic perforation of the colon have been described, reports of pneumothorax are much rarer. We, therefore, discuss the anatomic bases and the possible physiopathologic mechanisms responsible for this clinical complication.
Purpose:
Well-differentiated lung neuroendocrine tumors (Lu-NET) are classified as typical (TC) and atypical (AC) carcinoids, based on mitotic counts and necrosis. However, prognostic factors, other ...than tumor node metastasis (TNM) stage and the histopathological diagnosis, are still lacking. The current study is aimed to identify potential prognostic factors to better stratify lung NET, thus, improving patients’ treatment strategy and follow-up.
Methods:
A multicentric retrospective study, including 300 Lung NET, all surgically removed, from Italian and Spanish Institutions.
Results:
Median age 61 years (13–86), 37.7% were males, 25.0% were AC, 42.0% were located in the lung left parenchyma, 80.3% presented a TNM stage I-II. Mitotic count was ≥2 per 10 high-power field (HPF) in 24.7%, necrosis in 13.0%. Median overall survival (OS) was 46.1 months (0.6–323), median progression-free survival (PFS) was 36.0 months (0.3–323). Female sex correlated with a more indolent disease (T1; N0; lower Ki67; lower mitotic count and the absence of necrosis). Left-sided primary tumors were associated with higher mitotic count and necrosis. At Cox-multivariate regression model, age, left-sided tumors, nodal (N) positive status and the diagnosis of AC resulted independent negative prognostic factors for PFS and OS.
Conclusions:
This study highlights that laterality is an independent prognostic factors in Lu-NETs, with left tumors being less frequent but showing a worse prognosis than right ones. A wider spectrum of clinical and pathological prognostic factors, including TNM stage, age and laterality is suggested. These parameters could help clinicians to personalize the management of Lu-NET.
Well-differentiated lung neuroendocrine tumours (Lu-NETs), classified as typical (TC) and atypical (AC) carcinoids, represent 30% of NETs. Angiogenesis plays an essential role in NET development and ...progression. A higher vascular network is a marker of differentiation, with positive prognostic implications. Materials and Methods: We retrospectively evaluated microvessel density (MVD) by CD34 immunohistochemical (IHC) staining and hypoxia by IHC staining for Hypoxia-inducible factor 1α (HIF-1α), comparing right- and left-lung parenchyma in 53 lung NETs. Results: The median age was 66 years (39−81), 56.6% males, 24.5% AC, 40.5% left-sided tumours and 69.8% TNM stage I. The mitotic count was <2/10 per 10 HPF in 79.2%, and the absence of necrosis in 81.1%, 39.6% with Ki67, was ≤2%. The MVD, the number of vessels and the average vessel area median values were significantly higher in the right than the left parenchyma (p: 0.025, p: 0.019, p: 0.016, respectively). Hypoxia resulted present in 14/19 (73.6%) left tumours and in 10/20 (50%) right tumours in the parenchyma (p: 0.129). Conclusions: This study suggests a biological rationale for a different angiogenesis and hypoxia according to the Lu-NETs’ location. In our study, left primary tumours were less vascularized and most likely to present hypoxia than right primary tumours. This finding could have potentially useful prognostic and predictive implications for Lu-NETs.
Post‐bariatric hypoglycaemia (PBH) is a metabolic complication of bariatric surgery (BS), consisting of low post‐prandial glucose levels in patients having undergone bariatric procedures. While BS is ...currently the most effective and relatively safe treatment for obesity and its complications, the development of PBH can significantly impact patients' quality of life and mental health. The diagnosis of PBH is still challenging, considering the lack of definitive and reliable diagnostic tools, and the fact that this condition is frequently asymptomatic. However, PBH's prevalence is alarming, involving up to 88% of the post‐bariatric population, depending on the diagnostic tool, and this may be underestimated. Given the prevalence of obesity soaring, and an increasing number of bariatric procedures being performed, it is crucial that physicians are skilled to diagnose PBH and promptly treat patients suffering from it. While the milestone of managing this condition is nutritional therapy, growing evidence suggests that old and new pharmacological approaches may be adopted as adjunct therapies for managing this complex condition.
PDF
