9 research outputs found
The effect of two additional dry-land active warm-up protocols on the 50-m front-crawl swimming performance
Get PDFPurpose. The purpose of the study was to compare the effectiveness of 2 different dry-land active warm-up protocols on 50-m front-crawl swimming performance, biomechanical variables (stroke rate, stroke length, and stroke index), rate of perceived exertion, and exercise heart rate in swimmers of both genders.Methods. The total of 10 male and 9 female national-level swimmers completed a standardized 1000-m in-water warm-up protocol followed by a 30-min transition phase and a 50-m front-crawl time-trial. During this 30-min period, each swimmer executed, on different occasions, a protocol consisting of either a dynamic stretching routine (stretch) or a power exercise circuit (power) of equal duration (~ 5 min) in a randomized sequence. A control condition (control) including a passive recovery strategy after the in-water warm-up protocol was also analyzed.Results. An improvement in 50-m time-trial performance was demonstrated in male swimmers after executing the power protocol (p = 0.034), while in female swimmers a trend towards faster performance times was revealed after the stretch protocol (p = 0.064). Stroke index was improved after the stretch routine only in female swimmers (p = 0.010). Stroke rate, stroke length, rate of perceived exertion, and exercise heart rate showed no differences among all the 3 conditions in either gender (p > 0.05).Conclusions. Male and female swimmers respond differently to a power or a dynamic stretching protocol. In addition, the variation in responses to different warm-up conditions highlights the importance of individualizing the dry-land warm-up procedure to promote maximum performance during 50-m front-crawl swimming events.Dalamitros, Athanasios-will be generated-orcid-0000-0003-1069-2146-600Vagios, AthanasiosToubekis, Argyris-will be generated-orcid-0000-0002-2040-354X-600Tsalis, George-will be generated-orcid-0000-0003-2155-5593-600Clemente-Suárez, Vicente Javier-will be generated-orcid-0000-0002-2397-2801-600Manou, Vasiliki-will be generated-orcid-0000-0002-0912-3125-60
Willy Loman and the American Dream
No full textThe unavoidable question in Death of a Salesman that lingers is whether Willy Loman is an attack, defense or ploy in the representation of the American dream. Death of a Salesman has created considerable controversy for its theatrical style, production values and its dramatic content. When first exposed to it as an underclassman, I wasn’t affected by the controversy of its theatrical style or production decisions. I accepted it as a modern tragedy and a hybrid of American Realism and German Expressionism without reservation about its theatrical style. But I found it hard to accept and participate in the political debates it seemed to engender; in fact, I was offended by its obvious ambiguity and invitation to argument. I never felt comfortable in either position, considering Death of a Salesman as being a defense of or an attack upon the American Capitalist system or the pursuit of the American dream. These arguments seemed contrived to me, and these issues and the intentional ambiguity of Miller in Death of a Salesman smacked of manipulation and seemed to be career moves designed to enhance the appeal of the play by creating controversy. Miller readily admitted that he had written his previous play, All My Sons, to shock and promote discussion (S. C. Abbotson 1999, 46). So, why can’t Willy be a straw man that was created to bring more and continuing controversy and attention to Miller’s work, which had just caused political commotion with the play All My Sons about war profiteering. Of course, Miller was accused of being a communist when that play appeared in 1947, also (A. Miller, Time bends 1987, 238). It became clear to me that Death of a Salesman could be interpreted as an oblique attack on the American dream or an ambiguous defense of that dream that one could embrace or reject according for personal or partisan reasons. It was a clever manipulation by the author designed to capitalize on his reputation as a leftist and the controversy of All My Sons to give the play more appeal and to enhance its chance at success, blending ideological controversy with the universal themes of family, love and death.Master of Arts (MA)Liberal StudiesUniversity of Michigan-Flinthttps://deepblue.lib.umich.edu/bitstream/2027.42/143408/1/YoungV.pd
Intraductal papilloma of the male breast: A case report and review of the literature
No full textIntraductal papilloma is a benign neoplasm rarely found in the male breast. In this report, we present the case of a 55-year-old Caucasian man who presented with spontaneous bloody nipple discharge of the right breast. Ultrasonic and mammographic investigations revealed a sub-centimetre solid mass within a dilated duct. He underwent a total duct excision. Histopathologic examination confirmed a benign intraductal papilloma with no evidence of atypia or malignancy. A systematic review of the literature revealed six published cases of intraductal papillomas in men. Clinical presentation is the same as in women with single duct blood stained discharge being the most common presenting symptom. Surgical excision offers both histologic confirmation and definitive treatment. There is one case where the lump was not removed and progressed to malignancy years later. Male intraductal papillomas may be associated to medical treatments with hormonal activity given for other reasons or endocrine abnormalities. © The Author(s) 2019
Malignant melanoma of the breast: controversies in the diagnosis and therapeutic management of a rare nosologic entity
No full textIncreased expression of Toll-like receptors 2, 3, 4 and 7 mRNA in the kidney and intestine of a septic mouse model
No full textToll-like receptors (TLRs) are the key regulators of innate and adaptive immunity and are highly expressed during sepsis. Thus, studying the expression of TLRs in an animal septic model might indicate their possible association with acute kidney injury in sepsis. Seventy-two male C57BL/6J mice were used for this study. Randomly, these animals were divided into 6 groups (N = 12/group): 3 control and 3 septic groups depending on the euthanasia time (24 h, 48 h, 72 h). Septic groups underwent cecal ligation and puncture (CLP) to induce peritonitis, while control groups had a sham operation. Hematological tests were performed in serum for immune biomarkers; immunohistochemistry, morphometry and qRT-PCR analysis were used on both kidney and intestine tissues to evaluate the expression of TLR 2, 3, 4 and 7 in a septic process. At the end of each experimental period, we found that TLRs 2, 3, 4 and 7 were expressed in both tissues but there were differences between those at various time points. Also, we found that mRNA levels were significantly higher in qRT-PCR evaluation in septic groups than control groups in both kidney and intestinal tissues (p < 0.05); showing a steady increase in the septic groups as the time to euthanasia was prolonged (p < 0.05). Overall, our study provides a suggestion that TLRs 2, 3, 4 and 7 are highly expressed in the kidneys of septic mice and especially that these TLRs are sensitive and specific markers for sepsis. Finally, our study supports the diagnostic importance of TLRs in AKI and provides an insight on the contribution of septic mice models in the study of multi organ dysfunction syndrome in general. © 2019, The Author(s)
The ChoCO-W prospective observational global study: Does COVID-19 increase gangrenous cholecystitis?
No full textBackground: The incidence of the highly morbid and potentially lethal gangrenous cholecystitis was reportedly increased during the COVID-19 pandemic. The aim of the ChoCO-W study was to compare the clinical findings and outcomes of acute cholecystitis in patients who had COVID-19 disease with those who did not. Methods: Data were prospectively collected over 6 months (October 1, 2020, to April 30, 2021) with 1-month follow-up. In October 2020, Delta variant of SARS CoV-2 was isolated for the first time. Demographic and clinical data were analyzed and reported according to the STROBE guidelines. Baseline characteristics and clinical outcomes of patients who had COVID-19 were compared with those who did not. Results: A total of 2893 patients, from 42 countries, 218 centers, involved, with a median age of 61.3 (SD: 17.39) years were prospectively enrolled in this study; 1481 (51%) patients were males. One hundred and eighty (6.9%) patients were COVID-19 positive, while 2412 (93.1%) were negative. Concomitant preexisting diseases including cardiovascular diseases (p < 0.0001), diabetes (p < 0.0001), and severe chronic obstructive airway disease (p = 0.005) were significantly more frequent in the COVID-19 group. Markers of sepsis severity including ARDS (p < 0.0001), PIPAS score (p < 0.0001), WSES sepsis score (p < 0.0001), qSOFA (p < 0.0001), and Tokyo classification of severity of acute cholecystitis (p < 0.0001) were significantly higher in the COVID-19 group. The COVID-19 group had significantly higher postoperative complications (32.2% compared with 11.7%, p < 0.0001), longer mean hospital stay (13.21 compared with 6.51 days, p < 0.0001), and mortality rate (13.4% compared with 1.7%, p < 0.0001). The incidence of gangrenous cholecystitis was doubled in the COVID-19 group (40.7% compared with 22.3%). The mean wall thickness of the gallbladder was significantly higher in the COVID-19 group [6.32 (SD: 2.44) mm compared with 5.4 (SD: 3.45) mm; p < 0.0001]. Conclusions: The incidence of gangrenous cholecystitis is higher in COVID patients compared with non-COVID patients admitted to the emergency department with acute cholecystitis. Gangrenous cholecystitis in COVID patients is associated with high-grade Clavien-Dindo postoperative complications, longer hospital stay and higher mortality rate. The open cholecystectomy rate is higher in COVID compared with non -COVID patients. It is recommended to delay the surgical treatment in COVID patients, when it is possible, to decrease morbidity and mortality rates. COVID-19 infection and gangrenous cholecystistis are not absolute contraindications to perform laparoscopic cholecystectomy, in a case by case evaluation, in expert hands. Graphical abstract: [Figure not available: see fulltext.] © 2022, The Author(s)
COVID-19 infection is a significant risk factor for death in patients presenting with acute cholecystitis: a secondary analysis of the ChoCO-W cohort study
Get PDFBackground: During the coronavirus disease (COVID-19) pandemic, there has been a surge in cases of acute cholecystitis. The ChoCO-W global prospective study reported a higher incidence of gangrenous cholecystitis and adverse outcomes in COVID-19 patients. Through this secondary analysis of the ChoCO-W study data, we aim to identify significant risk factors for mortality in patients with acute cholecystitis during the COVID-19 pandemic, emphasizing the role of COVID-19 infection in patient outcomes and treatment efficacy.” Methods: The ChoCO-W global prospective study reported data from 2546 patients collected at 218 centers from 42 countries admitted with acute cholecystitis during the COVID-19 pandemic, from October 1, 2020, to October 31, 2021. Sixty-four of them died. Nonparametric statistical univariate analysis was performed to compare patients who died and patients who survived. Significant factors were then entered into a logistic regression model to define factors predicting mortality. Results: The significant independent factors that predicted death in the logistic regression model with were COVID-19 infection (p < 0.001), postoperative complications (p < 0.001), and type (open/laparoscopic) of surgical intervention (p = 0.003). The odds of death increased 5 times with the COVID-19 infection, 6 times in the presence of complications, and it was reduced by 86% with adequate source control. Survivors predominantly underwent urgent laparoscopic cholecystectomy (52.3% vs. 23.4%). Conclusions: COVID-19 was an independent risk factor for death in patients with acute cholecystitis. Early laparoscopic cholecystectomy has emerged as the cornerstone of treatment for hemodynamically stable patients
The ChoCO-W prospective observational global study: Does COVID-19 increase gangrenous cholecystitis?
Get PDFBACKGROUND: The incidence of the highly morbid and potentially lethal gangrenous cholecystitis was reportedly increased during the COVID-19 pandemic. The aim of the ChoCO-W study was to compare the clinical findings and outcomes of acute cholecystitis in patients who had COVID-19 disease with those who did not. METHODS: Data were prospectively collected over 6 months (October 1, 2020, to April 30, 2021) with 1-month follow-up. In October 2020, Delta variant of SARS CoV-2 was isolated for the first time. Demographic and clinical data were analyzed and reported according to the STROBE guidelines. Baseline characteristics and clinical outcomes of patients who had COVID-19 were compared with those who did not. RESULTS: A total of 2893 patients, from 42 countries, 218 centers, involved, with a median age of 61.3 (SD: 17.39) years were prospectively enrolled in this study; 1481 (51%) patients were males. One hundred and eighty (6.9%) patients were COVID-19 positive, while 2412 (93.1%) were negative. Concomitant preexisting diseases including cardiovascular diseases (p < 0.0001), diabetes (p < 0.0001), and severe chronic obstructive airway disease (p = 0.005) were significantly more frequent in the COVID-19 group. Markers of sepsis severity including ARDS (p < 0.0001), PIPAS score (p < 0.0001), WSES sepsis score (p < 0.0001), qSOFA (p < 0.0001), and Tokyo classification of severity of acute cholecystitis (p < 0.0001) were significantly higher in the COVID-19 group. The COVID-19 group had significantly higher postoperative complications (32.2% compared with 11.7%, p < 0.0001), longer mean hospital stay (13.21 compared with 6.51 days, p < 0.0001), and mortality rate (13.4% compared with 1.7%, p < 0.0001). The incidence of gangrenous cholecystitis was doubled in the COVID-19 group (40.7% compared with 22.3%). The mean wall thickness of the gallbladder was significantly higher in the COVID-19 group [6.32 (SD: 2.44) mm compared with 5.4 (SD: 3.45) mm; p < 0.0001]. CONCLUSIONS: The incidence of gangrenous cholecystitis is higher in COVID patients compared with non-COVID patients admitted to the emergency department with acute cholecystitis. Gangrenous cholecystitis in COVID patients is associated with high-grade Clavien-Dindo postoperative complications, longer hospital stay and higher mortality rate. The open cholecystectomy rate is higher in COVID compared with non -COVID patients. It is recommended to delay the surgical treatment in COVID patients, when it is possible, to decrease morbidity and mortality rates. COVID-19 infection and gangrenous cholecystistis are not absolute contraindications to perform laparoscopic cholecystectomy, in a case by case evaluation, in expert hands
