[Experience with the of treatment renal cell carcinoma with thrombus in inferior vena cava and right atrium]. / Experiencia en el tratamiento del carcinoma de células renales con trombo en vena cava inferior y aurícula derecha.

Retrospective analysis of definite staging and surgery results in 17 patients with renal cell tumour disseminated to lower cava vein who underwent radical nephrectomy and tumoral thrombectomy. Magnetic resonance predicted presence and level of tumoral thrombus in 100% and 88% cases, respectively. Neither venacavography or doppler echography provided additional information. Dissemination was infrahepatic in 9 (53%) cases, suprahepatic in 4 (24%) and to the right atrium in 4 (23%). Cardiopulmonary by-pass and hypothermic cardioplegia was used in 9 (53%) cases. Operative mortality and morbidity rates were 11% and 65%, respectively. The level of the thrombus did not significantly affect the prognosis which was highly affected however by regional node invasion. In all, CT and MRI can determine the extension and level of the cava vein thrombus in most cases. In our experience, disease-free survival is determined by the pathological stage and not by the extent of the cava thrombus. Radical nephrectomy and tumoral thrombectomy can provide long survival to patients with locoregional disease.

Biathlon shooting performance after exercise of different intensities.

Biathletes commonly reduce their skiing intensity as they approach the firing line. However, it is not clear how the intensity of the previous exercise affects their shooting results. The purpose of this investigation was to assess shooting performance among elite American biathletes immediately after exercise of various intensities. Shooting performance was assessed from measures of shooting accuracy, shooting precision, and stability of hold. It was found that exercise intensity had minimal effect on shooting accuracy and precision for prone shooting, but did affect these measures for shooting in the standing position. In addition, stability of hold was affected more by exercise intensity for shooting in the standing position compared with prone shooting. If these results can be transferred to competitive biathlon, it is suggested that the intensity of exertion immediately prior to biathlon shooting has minimal influence on prone shooting performance, but does affect shooting in the standing position by altering the stability of the hold.