Flash glucose monitoring system in patients with type 1 diabetes in healthcare center in Brazil: real world data from a short-term prospective study

ABSTRACT Objectives: To evaluate the alternate use of flash glucose monitoring (FGM) with self-monitoring blood glucose (SMBG), in patients with type 1 diabetes (T1D). Materials and methods: Two weeks of open FGM (P2), both preceded (P1) and followed by 2 weeks (P3) of SMBG with a blinded FGM system. Mean absolute relative difference (MARD) was calculated by (-FGMi − SMBGi-) / SMBGi, where it was a paired data sample. Results: In total, 34 patients were evaluated. Time in range (TIR) did not change between P1 and P2. In 12 patients (35.3%), TIR increased from 40% at P1 to 52% at P2 (p = 0.002) and in 22 (64.7%), TIR decreased or did not change. FGM use resulted in decreased % time spent in hypoglycemia (<70 mg/dL) (6.5% vs. 5.0%; p = 0.005), increased % time spent in hyperglycemia (>180 mg/dL) (44.5% to 51%; p = 0.046) with no significant change in % TIR. The proportion of patients who reached sensor-estimated glycated hemoglobin (eA1c) < 7% decreased from 23.5% at P1 to 12.9% at P2, p = 0.028. For the whole sample, the MARD between the two methods was 15.5% (95% CI 14.5-16.6%). For normal glucose range, hyperglycemic levels and hypoglycemic levels MARD were 16.0% (95% CI 15.0-17.0%), 13.3% (95% CI 11.5-15.2%) and 23.4% [95% CI 20.5-26.3%)], respectively. Conclusion: FGM after usual SMBG decreased the % time spent in hypoglycemia concomitant with an undesired increase in % time spent in hyperglycemia. Lower accuracy of FGM regarding hypoglycemia levels could result in overcorrection of hypoglycemia.

La rentabilidad del viraje en nadadoras del estilo libre

La investigación se refiere a un estudio de la rentabilidad de la acción del viraje del estilo libre en nadadoras escolares. El objetivo para la investigación se centró en evaluar las características temporales durante la acción del viraje en nadadoras de la categoría 13 y 14 años de la provincia de Sancti Spíritus. Para la recogida de la información, se utilizaron los métodos del nivel empírico: la observación científica, así como la de medición. Se utilizaron dos cámaras de videos, ubicadas en serie, y una cámara subacuática marca Sony. Para el análisis temporal, se requirió del software Kinovea, ver 0.9.3. Se aplicó el test de 15 m. para comprobar la rentabilidad del viraje. Se pudo comprobar una pobre efectividad de este elemento técnico en el estilo libre en las nadadoras evaluadas, lo que mostró, de forma generalizada, deficiencias durante la fase de impulso y se comprobó la formación de ángulos muy abiertos de las piernas que favoreció un déficit en la utilización de la potencia de las piernas durante el empuje de la pared, aspecto este que ayudó a disminuir el deslizamiento y comenzar a realizar los movimientos de salida a la superficie de forma prematura, aumentó el tiempo de forma general en la ejecución del viraje, concluyendo que para las categorías escolares es oportuno obtener ángulos entre las articulaciones de tobillos, rodillas y cadera en el rango de los 90° y 110° al momento de iniciar el impulso de la pared.

A pesquisa diz respeito a um estudo sobre a rentabilidade da ação de viragem em estilo livre em nadadores escolares. O objectivo da investigação foi centrado na avaliação das características temporárias durante a ação de viragem em nadadores de 13 e 14 anos de idade na província de Sancti Spíritus. Para a recolha de informação, foram empregues métodos empíricos: observação científica e medição. Foram instaladas duas câmaras de vídeo, colocadas em série, e uma câmara subaquática Sony. Para a análise temporal, foi utilizado o software Kinovea, ver 0.9.3. O teste de 15 m foi executado para verificar a relação custo-benefício da curva. Foi possível constatar uma baixa eficácia deste elemento técnico no estilo livre dos nadadores avaliados, que mostraram, em geral, deficiências durante a fase de impulso e a formação de ângulos de pernas muito abertos que favoreceram um défice na utilização da força das pernas durante o impulso para a parede, Este aspecto permitiu reduzir o deslizamento e começar a realizar os movimentos de saída para a superfície antecipadamente, aumentou o tempo total na execução da curva, concluindo-se que para as categorias escolares é adequado obter ângulos entre o calcanhar, o joelho e as articulações da anca na gama de 90° e 110° no momento de iniciar o impulso da parede.

The research refers to a study of the profitability of the freestyle turning action in school swimmers. The objective of the research was focused on evaluating the temporal characteristics during the action of the turn in swimmers of the 13 and 14 years old category in the province of Sancti Spíritus. For the collection of information, the empirical level methods used were: scientific observation, as well as measurement. Two video cameras, placed in series, and a Sony underwater camera were used. For the temporal analysis, the Kinovea software, ver 0.9.3, was used. The 15 m test was applied to check the profitability of the turn. It was possible to verify a poor effectiveness of this technical element in the freestyle in the swimmers evaluated, which showed, in a generalized way, deficiencies during the impulse phase and the formation of very open angles of the legs that favored a deficit in the use of the power of the legs during the wall push, This aspect helped to decrease the sliding and to begin to perform the exit movements to the surface prematurely, increased the time in general in the execution of the turn, concluding that for the school categories it is appropriate to obtain angles between the ankle, knee and hip joints in the range of 90° and 110° at the moment of initiating the wall push.

Efecto del calentamiento activo y de diferentes intervalos de recuperación sobre el rendimiento en natación / Effect of active warm-ups and different recovery intervals on swimming performance

Resumen El propósito fue determinar el efecto del calentamiento activo con diferentes intervalos de recuperación en el rendimiento deportivo, en las pruebas de 50 y 200 metros libre. El estudio contó con la participación de 17 atletas (edad 13.5 ± 2.18 años), inscritos ante la Federación Costarricense de Deportes Acuáticos, con experiencia de entrenamiento y competición de 4.47 ± 1.28 años. Previo a la ejecución de las pruebas 50 y 200 metros libre, se realizaron 4 condiciones experimentales: Control (sin realizar calentamiento); Calentamiento (960 m) + descanso 20 min; Calentamiento (960 m) + descanso 10 min; Calentamiento (960 m) sin descanso. El orden de ejecución de las pruebas (50 y 200 metros libre) y la ejecución de las condiciones experimentales fueron asignadas de forma aleatoria. El análisis estadístico se realizó mediante ANOVA de una vía de medidas repetidas, p < 0.05. Los resultados indicaron que no existió diferencia significativa en el rendimiento en una prueba de 50 m libre (F = 0.83, p = 0.48) ni en la prueba de 200 m libre (F = 0.88, p = 0.46), al realizar un calentamiento activo respecto a no realizarlo. No hubo influencia de los diferentes tiempos de recuperación en el rendimiento en ambas pruebas. Se observaron diferentes patrones de respuesta individual a las condiciones experimentales. Se concluye que, de manera grupal, en nadadores jóvenes con poca experiencia, ejecutar un calentamiento activo previo a las pruebas de 50 y 200 metros libre, no mejora el rendimiento. Se recomienda que el entrenador ponga atención a la respuesta individualizada, para que elija el mejor protocolo (calentamiento o no) para mejorar el rendimiento deportivo de sus atletas.

Abstract The purpose of the paper was to determine the effect of active warm-ups with different recovery intervals in sport performance in 50m and 200m freestyle swimming. Seventeen athletes (13.5 ± 2.18 years old) registered with the Costa Rican Federation of Water Sports, with training and competition experience of 4.47 ± 1.28 years participated in this study. Before the 50m and 200m freestyle swimming tests, four experimental conditions were conducted: Control (without warm-up), Warm-up (960m) + 20 min rest, Warm-up (960m) + 10 min rest, Warm-up (960m) without rest. The order of the tests (50m and 200m freestyle) and the experimental conditions were randomly assigned. The statistical analysis used a one-way ANOVA of repeated measures, p < .05. No significant difference was found in performance in 50m or 200m freestyle swimming tests (F = 0.83, p = .48) (F = 0.88, p = .46), respectively, when using active warm-ups or not. Neither was there an effect of the different recovery times on performance in both swimming tests. Different patterns of individual responses were observed in the experimental conditions. It is concluded that, as a group, an active warm-up before 50m and 200m freestyle swimming tests does not improve the performance of young inexperienced swimmers. However, the coach is recommended to pay attention to individualized responses to select the best protocol (having warm-up or not) to improve athletes' performance.

Resumo O propósito foi determinar o efeito do aquecimento ativo com diferentes intervalos de recuperação no desempenho esportivo, nas provas de 50 e 200 metros livres. O estudo contou com a participação de 17 atletas (idade 13,5 ± 2,18 anos), inscritos na Federação Costarriquenha de Esportes Aquáticos, com experiência de treinamento e competição de 4,47 ± 1,28 anos. Previamente à execução das provas de 50 e 200 metros livres, foram realizados 4 condicionamentos experimentais: controle (sem aquecimento); aquecimento (960 m) mais descanso de 20 min; aquecimento (960 m) mais descanso de 10 min; aquecimento (960 m) sem descanso. A ordem de execução das provas (50 e 200 metros livres) e a execução dos condicionamentos experimentais foram atribuídas de maneira aleatória. A análise estatística foi realizada por meio da ANOVA de uma via de medidas repetidas, p < 0,05. Os resultados indicaram que não existiu diferença significativa no desempenho em uma prova de 50 m livres (F = 0,83, p = 0,48) e, tampouco, na prova de 200 m livres (F = 0,88, p= 0,46) ao realizar um aquecimento ativo em comparação a não o realizar. Não houve influência dos diferentes tempos de recuperação no desempenho em ambas as provas. Foram observados diferentes padrões de resposta individual aos condicionamentos experimentais. Conclui-se que, de modo grupal, em nadadores jovens com pouca experiência, realizar um aquecimento ativo prévio às provas de 50 e 200 metros livres, não melhora o desempenho. Recomenda-se que o treinador preste atenção na resposta individualizada para escolher o melhor protocolo (aquecimento ou não), buscando o aperfeiçoamento do desempenho esportivo de seus atletas.

Efectos de la pliometría en la fuerza explosiva de miembros inferiores en la lucha libre senior / Effects of plyometrics on the explosive strength of lower limbs in senior freestyle wrestling

RESUMEN Introducción: La fuerza explosiva es la capacidad física de generar una mayor fuerza muscular en un menor tiempo sin pérdida de eficacia, lo que es un componente determinante de la preparación deportiva y un indicador indirecto del rendimiento en lucha deportiva. Objetivo: Mejorar la fuerza explosiva en miembros inferiores a través de ejercicios pliométricos en luchadores libres, categoría senior. Métodos: Estudio cuasi-experimental de corte correlativo, para el cual se aplicó un programa pliométrico de tres fases, en miembros inferiores, conformado por una población de 15 luchadores (sexo masculino, sub-21 años), y fue evaluado el estímulo en la capacidad fuerza explosiva. Resultados: Se estableció mejoras significativas en la prueba de salto vertical (SV: p = 0,000), salto horizontal (SH: p = 0,000), carrera en 20 m (C20m: p = 0,000) y el test de salto 8 (S8: p = 0,001), y en todos los casos se favoreció al postest. Se determinó una correlación lineal positiva moderada entre SV y SH (0,50), una correlación negativa moderada entre SH y C20m (-0,58), una correlación negativa muy baja entre SV y C20m (-0,03), una correlación positiva moderada entre SV y S8 (0,61), una correlación positiva muy baja entre SH y S8 (0,16) y una correlación positiva moderada entre C20m y S8 (0,59). Conclusiones: Con la intervención pliométrica se demuestra una mejora significativa en la fuerza explosiva de miembros inferiores, lo que resulta en una alternativa eficaz para mejorar indirectamente el rendimiento deportivo. De las 6 correlaciones lineales realizadas, 4 fueron de índole moderada, esto evidencia que la potenciación pliométrica de un plano muscular específico puede mejorar consecutivamente otros planos musculares relacionados con la rapidez y la fuerza explosiva.

ABSTRACT Introduction: Explosive strength is the physical capacity to generate greater muscular strength in a shorter time without losing effectiveness. This is a crucial component of sports training and an indirect indicator of yield in wrestling. Objective: Improve the explosive strength of the lower limbs through plyometric exercises performed by senior freestyle wrestlers. Methods: A correlational quasi-experimental study was conducted based on a three-stage plyometric program for the lower limbs. The study population was 15 wrestlers (male sex, age under 21 years) who were evaluated for explosive strength capacity. Results: Significant improvement was established in the following tests: vertical jump (VJ: p = 0.000), horizontal jump (HJ: p = 0.000), 20-meter dash (D20m: p = 0.000) and jump 8 (J8: p = 0.001). In all cases the post-test obtained better results. Determination was made of a moderate positive linear correlation between VJ and HJ (0.50), a moderate negative correlation between HJ and C20m (-0.58), a very low negative correlation between VJ and C20m (-0.03), a moderate positive correlation between VJ and J8 (0.61), a very low positive correlation between HJ and J8 (0.16) and a moderate positive correlation between C20m and J8 (0.59). Conclusions: The plyometric intervention was found to significantly improve the explosive strength of lower limbs, thus becoming an effective alternative to indirectly enhance sport yield. Of the six linear correlations performed, four were moderate, which shows that plyometric strengthening of a specific muscular plane may consecutively improve other muscular planes related to speed and explosive strength.

A Case of Aortic Root Replacement in Freestyle Valve Reoperation / 日本心臓血管外科学会雑誌

Medtronic Freestyle Stentless bioprosthesis as well as stented bioprosthesis, can lead to structural valve deterioration (SVD) or disruption of the porcine aortic root. Seventeen years ago, a 52-year-old woman with aortitis syndrome underwent aortic root replacement in a full-root fashion for aortic regurgitation (AR) with a Freestyle aortic bioprosthesis. A recent follow-up echocardiogram revealed severe AR due possibly to SVD. Thus, we planned an aortic valve replacement (AVR) for AR with possible leaflet tear of the prosthesis. Upon completion of AVR while the aortotomy was being closed, however, a disruption in the porcine aortic wall was found. Root replacement had to be performed because of this finding. In stentless valve reoperation long after AVR with the full-root method, both the porcine aortic root and leaflets can be disrupted. Aortic root replacement may be necessary if preoperative images reveal dilatation, as well as disruption of the sinus of Valsalva.

Comparação da frequência cardíaca máxima entre teste máximo na natação e equações de predição

RESUMO O objetivo desse estudo foi verificar diferenças entre a frequência cardíaca máxima (FCM) obtida na natação em testes de 200 metros nas técnicas de nado crawl e peito e comparar a FCM dos testes com as obtidas através de 53 equações de predição. A amostra foi composta por dois grupos de nadadores, todos do sexo masculino, oito (22,87 ± 2,03 anos) fizeram o nado crawl e 14 (22±2,94 anos) o nado peito. Não houve diferenças significantes (p = 0,530) em relação às técnicas de nado. Comparando-se a FCM obtida e calculada, através do modelo de Bland Altman, foi observado que apenas para o nado crawl são indicadas equações de predição para a estimativa da FCM, na impossibilidade de feitura do teste máximo. Entre as equações, recomenda-se a FCM = 204-1,07 x idade.

ABSTRACT The aim of this study was to verify the differences between the Maximum Heart Rate (MHR) obtained in swimming in tests of 200 meters in two swimming strokes frontcrawl and breaststroke and to compare FCM of the tests with the obtained through 53 prediction equations. The sample consisted of two groups of swimmers, all male, 8 (22.87±2.03 years) performed freestyle and 14 (22±2.94 years) breaststroke. There were no significant differences (p=0.530) regarding the swimming strokes. Comparing the MHR obtained and calculated through the Bland Altman model, it was observed that only for freestyle are indicated prediction equations for the MHR estimation, in the impossibility of to perform a maximum test. Among the equations, the MHR = 204-1.07 x age is recommended.

RESUMEN El objetivo del estudio fue comprobar las diferencias entre la frecuencia cardíaca máxima (FCM) obtenida en natación en pruebas de 200 metros en las técnicas de crol y braza, y comparar las FCM de las pruebas con las obtenidas a través de 53 ecuaciones de predicción. La muestra estaba compuesta por dos grupos de nadadores, todos del sexo masculino, y 8 (22,87 ± 2,03 años) nadaron con estilo crol y 14 (22 ± 2,94 años) nadaron a braza. No hubo diferencias importantes (p = 0,530) en relación con las técnicas de natación. En comparación con la FCM obtenida y calculada, a través del modelo de Bland Altman, se observó que las ecuaciones de predicción para la estimación de la FCM solo estaban indicadas para crol, por la imposibilidad de realizar la prueba máxima. Entre las ecuaciones, se recomienda la FCM = 204-1,07 × edad.

Effect of perforator flap with preserved Choke vessel area in repairing the defect induced by tumor removal / 中华医学美学美容杂志

Objective To explore the clinical significance of protection "Choke vessel area" in the application of perforator flap to repair large defect of trunk after tumor resection.Methods A total of 62 patients (38 males and 24 females,aged from 19 to 79 years) from the Department of Plastic Surgery,Second Affiliated Hospital of Suzhou University underwent reconstructive surgery for large area defects of the trunk from March 2012 to January 2016.The perforator flap was designed according to the perforator location detected by Doppler before surgery.The flaps were harvested on the pedicle of perforators and dissected on the deep layer of deep fascia (including part of the myolemma).The areas of flap ranged from 5.0 cm × 10.0 cm to 19.0 cm × 22.0 cm.The donor site was sutured directly or local flap was transferred to repair.Results Flaps survived well in 59 of the 62 cases.The tip of flap was necrotic and healed after dressing change in 1 diabetic patient.The distal part of flap was necrotic on cuticular layer and healed after dressing change in another patient with scrotal defect.One patient had flap necrosis 10 days after operation and was repaired twice.The results were satisfied after following-up from 3 months to 2 years for 17 cases and from 6 months to 2 years for 25 cases.Fibrosarcoma protuberant and squamous cell carcinoma recurred in 1 case each,but the function and appearance were satisfactory after primary repair.Conclusions The procedure of preserving Choke vessel area can improve the blood supply of perforator flap and obtain larger survival area and survival quality.It is worthy of clinical application.

A Comparative Study Of Pulmonary Function Tests In Freestyle Wrestlers And Age Matched Sedentary Individuals

Objective of the current study was to determine the differences in Pulmonary function tests in Freestyle wrestlers and sedentary individuals. Materials and Methods: Study included 40 male Freestyle wrestlers and 40 male sedentary individuals who are not interested in any sport branches actively. Forced Vital Capacity (FVC), Forced Expiratory Volume in 1st second (FEV1), FEV1 % and Peak Expiratory Flow Rate (PEFR) are the Lung function parameters considered in this study and recorded using HELIOS 401 MEDSPIROR. Results: The arithmetic mean and standard deviations of the data were obtained for statistical evaluation. Results were analysed statistically using unpaired 't' test. Male wrestlers showed statistically significant higher values of FEV1 4.09 ± 0.109, FVC of 4.96 ± 0.45, PEFR of 4.570 ± 0.119 and FEV1 % of 82.48 ± 0.602 when compared to sedentary group. Conclusion: In Freestyle wrestlers higher values of Lung function tests were obtained when compared to sedentary individuals suggest that regular exercise has a significant role in improving lung functions.

Application of free-style perforator flap to repair nasal defect after tumor resection / 中华医学美学美容杂志

Objective To study the value of free-style perforator flap in repairing nasal defects after tumor resection.Methods On the basis of the guidance of free-style perforator flap design concept and the foundation of vascular localization by Doppler based on the ultrasonic echo intensity,combined with nasal beauty subunits,we designed free-style perforator flap in different forms such as V-Y advancing flap,rotating flap,and propeller flap,which had with free-style perforator in pedicle all.We transplanted the flaps to repair nasal defects after tumor resection.The area of the flaps was between 2 cm x 1.0 cm and 8.0 cm x 5.0 cm,and the diameter of the perforate vessel in the pedicle of flap was between 0.3 mm-3 mm,and some of the pedicles were composed of perforate vessel tube bundle.In order to reduce recurrence rate,the radiotherapy was performed according to the pathology in 1 month after surgery.Results In 31 cases of this group,29 cases were performed and the postoperative shape was good.1 case appeared postoperative hemorrhage,and the epidermis of flap formed blister because of greater tension,and the patient healed 10 days later after extraction the bubble fluid and changing medicine.The flap of 1 case was silted because the venous was blocked,and the acupuncture was treated,and then the flap got delayed union.23 cases received adjuvant radio therapy after surgery and fellowed up from 6 months to 5 years,showing that local profile and color were satisfacfory without tumor recurrence.Conclusions It is worthy of clinical promotion to designing freetype perforator flap and to repair defect after extensive nasal tumor resection on the basis of beauty subunits in nasal and vascular anatomy,which can not only reduce the recurrence rate by postoperative radiotherapy in time,but also realize better cosmetic requirements.

Aortic Insufficiency Caused by a Leaflet Tearing of the Medtronic Freestyle Stentless Aortic Bioprosthesis Complicated by Rheumatic Multivalvular Heart Disease / 日本心臓血管外科学会雑誌

<p>We report a case of an 85-year-old woman with severe aortic insufficiency caused by structural valve deterioration (SVD) of Medtronic Freestyle stentless aortic bioprosthesis (Freestyle valve) complicated by rheumatic multivalvular heart disease. The patient received an aortic valve replacement by using the modified sub-coronary method with a 21 mm Freestyle stentless porcine valve (Medtronic Inc., Minneapolis, MN, USA), for severe aortic valve stenosis at of the age of 71. The patient developed severe heart failure 14.5 years after the surgery. She was admitted for severe aortic insufficiency caused by a leaflet injury (tear) of the Freestyle valve. She also had had rheumatic mitral stenosis and secondary tricuspid insufficiency with severe pulmonary hypertension. Therefore, treating her heart failure was difficult, but surgery was performed. The leaflets of the stentless bioprosthesis were resected. The insertion of the needle suture into the annulus of the stentless valve was difficult because of calcification of the tissue. An aortic root enlargement procedure was performed using a bovine pericardial patch, enabling the insertion of the needle suture into the Dacron cloth at the bottom of the stentless valve, with 2-0 Ethibond threads and single sutures. We successfully performed an aortic valve re-replacement using an Open Pivot Mechanical Heart Valve (OPHV) 16 mm AP (Medtronic, Minneapolis, MN, USA), which was implanted by using the partial valve-in-valve technique. Simultaneously, mitral valve commissurotomy and tricuspid annuloplasty were performed. The patient had an uneventful postoperative recovery.</p>

Antropometría, composición corporal y somatotipo de las patinadoras de elite en patinaje artístico sobre ruedas: análisis por disciplinas / Anthropometry, body composition and somatotype characteristics of world class female roller skaters by discipline

El objetivo de este estudio fue describir y comparar las características antropométricas, composición corporal y somatotipo de patinadoras de patinaje artístico sobre ruedas por categorías (junior y senior) y por disciplinas (individual, parejas y danza). Fueron evaluadas 62 patinadoras profesionales (36 en la disciplina de libre, 13 en danza y 13 en parejas). El análisis estadístico utilizado fue una ANOVA para muestras independientes entre disciplinas, y una T de Student para las categorías (junior y senior). Entre la categoría junior y senior no se han encontrado diferencias estadísticas significativas. Las patinadoras junior presentaron un somatotipo endo-mesomorfo, y las patinadoras senior presentaron un somatotipo mesomorfo balanceado. El somatotipo de las patinadoras de parejas y danza fue el mesomórfico balanceado, y el de las patinadoras de libre fue endo-mesomórfico. Este estudio aporta datos biotipológicos de referencia para la población de elite de patinadoras sobre ruedas.

The aim of the study was to describe and compare anthropometric characteristics, body composition and somatotype of female roller skaters by levels (Junior and Senior) and by disciplines (freestyle, pairs and dance). Sixty-two world class female roller skaters were assessed (36 freestyle roller skaters, 13 dance roller skaters and 13 pair roller skaters). A one-way analysis of variance (ANOVA) was used to determine if significant differences existed in the anthropometric profile among skating discipline and a student t test in order to assess differences between junior and senior levels. There are no significant differences between junior and senior roller skaters. Junior female roller skaters show an endo-mesomorphic somatotype and senior female roller skaters show a balanced mesomorphic somatotype. Roller dance skaters and roller pair skaters show a balanced mesomorphic somatotype and roller freestyle skaters show an endo-mesomorphic somatotype. This paper, reports specific reference data for world class female roller skaters.

Reoperation in Two Patients with SJM Toronto SPV and Medtronic Freestyle Stentless Bioprosthetic Valves / 日本心臓血管外科学会雑誌

Stentless bioprosthetic valves have been implanted for treatment of aortic valve disease, especially in elderly patients ; these valves have the advantage of durability and excellent hemodynamics compared with stented bioprosthetic valves. Although good long-term results in patients with stentless bioprosthetic valves have been reported recently, reoperation has been gradually increasing. We performed reoperation for the SJM Toronto SPV and Medtronic Freestyle valves in one patient each. The SJM Toronto SPV was used in a 30-year-old woman ; however, 8 years later, the valve showed severe calcification and adhesions, and could not be completely removed (Case 1). The other reoperation case, wherein a 69-year-old man underwent aortic valve replacement with the Medtronic Freestyle 4 years previously, showed no adhesion around the implanted valve, which could be easily removed from the autologous aortic annulus. Consequently, the first patient required reimplantation of a small mechanical valve (SJM #19). In contrast, we were able to use a stentless bioprosthetic valve (Prima Plus #23) for the second patient. Further observations on stentless bioprosthetic valves are required.

Determinação do número adequado de repetições para a avaliação da virada no nado livre / Determination of appropriete number of repetition to evaluate the freestyle swimming turn / Determinación del número adecuado de repeticiones para la evaluación del volteo en el nado libre

O estudo propõe um procedimento para coletas de dados da virada no nado livre (número de execuções). Onze nadadores executaram 8 viradas cada um. Analisou-se as variáveis Pico de Força normalizado (PFn), Tempo de Contato (TC), Impulso (Imp) e Tempo de Virada em 10 metros (TV10m). A estabilidade visual quanto ao número de execuções foi verificada pelo cálculo do coeficiente de variação acumulado que apresentou curvas com variações discretas. Foi verificado se ocorria diferença entre as médias acumuladas usando a análise de variância (ANOVA) entre os diferentes agrupamentos. Não houve diferenças significativas. Para confirmar o número mínimo de repetições, confrontou-se os dados pelo teste de U de Mann-Whitney. Não houve diferenças significativas. Observou-se que três execuções válidas são o suficiente para avaliar o desempenho na virada.

The aim of this study was to develop a procedure of data collection on freestyle swimming turn (number of repetition). Eleven swimmers executed 8 turns each one. The measured variables were Normalized Peak Force (PFn), Contact Time (TC), Impulse (Imp) and Turn Time in 10 meters (TV10m). The visual stability as for the number of executions was checked through the calculation of the accumulate coefficient of variation that presents small variations curves. No significant differences were found between the accumulate averages using ANOVA between the different groupings and also for the confirmation of the least number of repetitions, it chose in confronting the data, through the Mann-Whitney U test carried out between the variables. Was found that three valid executions are enough to evaluate the performance in front freestyle turn.

El estudio propone un procedimiento para colectas de datos del volteo en el nado libre (número de ejecuciones). Once nadadores ejecutaron 8 volteos cada uno. Se analizo las variables de Pico de Fuerza normalizado (PFn), Tiempo de Contacto (TC), Impulso (Imp) e Tiempo de Viragem en 10 metros (TV10m). La estabilidad visual cuanto al número de ejecuciones fue verificad por el cálculo del coeficiente de variable acumulado que presento curvas con variaciones discretas. Fue verificado si ocurrían diferencias entre las medidas acumuladas usando el análisis de variabilidad (ANOVA) entre los diferentes agrupamientos. No hubo diferencias significativas. Para confirmar el número mínimo de repeticiones se compararon los datos de U de Mann-Whitney. No hubo diferencias significativas. Se observo que tres ejecuciones válidas son suficientes para evaluar el desempeño en el volteo.