Decision Making and Defensive Effectiveness of Ball Screen in Top-Level Basketball / Toma de decisiones y eficacia defensiva del bloqueo con balón en el baloncesto de alto nivel

The objective of this study is to analyze the effectiveness of the defensive actions of the pick and roll in basketball by ACB League teams throughout a full season (2010-11), contrasting the results obtained with the opinion of basketball experts on the decision-making process regarding this game action. The research uses direct observation (observational methodology) and indirect observation (in-depth interviews). An observational instrument is used to analyze the actions of pick and roll and this is recorded using the software Dartfish TeamPro v.4.5. For the in-depth interviews, an indirect observation instrument is built and validated. The significant association between different elements of the game and defensive efficiency is determined using Chi-square and a polar coordinate analysis. 8267 actions have been analyzed, of which 26.9% correspond to ball screens. Significant differences (p <.05) are detected in the distribution of the different types of defensive aid from the defender of the ball handler and the defender of the screener in relation to defensive effectiveness, the most widely used option being the chase and the show. The coaches express in their in-depth interviews why “pick and roll is such a widely used and effective action” (Scariolo).(AU)

Aerobic Fitness and Technical Efficiency at High Intensity Discriminate between Elite and Subelite Tennis Players.

The aim of this study was to determine whether selected physiological, performance and technical parameters derived from an on-court test are capable of discriminating between tennis players of national and international levels. 38 elite and subelite tennis players were divided into international level (INT, n=8) and national level players (NAT, n=30). They all performed a specific endurance field test, and selected physiological (maximum oxygen uptake [V˙O2max], and ventilatory thresholds [VT1 and VT2]), performance (test duration, final stage and hits per test) and technical (technical effectiveness [TE]) parameters were compared. INT showed greater V˙O2max, VO2 at VT2 (ml·kg(-1)·min(-1)), test duration (s), final stage (no.), hits per test (no.) and TE (% of successful hits), as compared with NAT (p<0.05). At high exercise intensity (stages 5 and 6), the INT achieved better TE than NAT (p=0.001-0.004), and the discriminant analyses showed that these technical parameters were the most discriminating factors. These results suggest that this specific endurance field test is capable of discriminating between tennis players at national and international levels, and that the better aerobic condition of the INT is associated with better technical efficiency at higher exercise intensities.

Relación entre parámetros técnicos y fisiológicos en tenistas de competición / Relationship between technical and physiological parameters in competition tennis players

Durante los últimos años ha aumentado el interés para evaluar parámetros fisiológicos y técnicos en jugadores de tenis, actualmente existen pruebas que permiten registrar paralelamente estos parámetros en la misma pista de tenis. El objetivo de este estudio es determinar las relaciones entre parámetros técnicos y fisiológicos derivados de la aplicación de una prueba de resistencia específica en tenis. 38 jugadores de competición realizaron una prueba continua e incremental y se registraron parámetros técnicos (efectividad técnica (ET), punto de disminución de efectividad técnica (PDET)) y parámetros fisiológicos (consumo máximo de oxígeno (VO2max), primer y segundo umbrales ventilatorios (UV1 y UV2)). Se encontró una relación significativa entre PDET y UV2 (r=0,65; p<0,05) y entre ET y VO2max (r=0,459; p<0,01). En conclusión, los jugadores con mejor perfil aeróbico tendieron a obtener mejores resultados de ET y se observó una tendencia a disminuir la ET a partir de la aparición del UV2 (AU)

In recent years there has been an increased interest to assess physiological and technical parameters in tennis players; currently there are tests that allow registering these parameters in parallel on the tennis court. The aim of this study is to determine the relationships between technical and physiological parameters resulting from the application of a specific endurance test procedure for tennis players. 38 competitive male tennis players performed a continuous and incremental field test and technical (technical effectiveness [TE], point of decreasing TE [PDTE]) and physiological parameters (maximal oxygen uptake (VO2max), first and second ventilatory thresholds (VT1 and VT2)) were recorded. We found a significant relationship between PDTE and VT2 (r = 0.365, P <0.05) and between TE and VO2max (r = 0.459, P <0.01). In conclusion, players with a better aerobic profile tended to get better results in terms of TE and showed a tendency to decrease TE from the appearance of VT2 (AU)

Intensity profile during an ultra-endurance triathlon in relation to testing and performance.

We examined the heart rate (HR)-based intensity profile during an ultra-endurance triathlon (UET) estimated from the individual HR-oxygen uptake (˙VO2) relationship during specific graded tests, relating it to race performance. 9 male ultra-endurance triathletes completed the study. Before racing, subjects performed graded exercise tests involving cycle (C) ergometry, treadmill running (R) and free swimming (S) for peak ˙VO2 and HR at ventilatory thresholds (VT). Exercise-specific HR-˙VO2 regression equations were developed. Mean race HR was higher during S (149.2 (10.1) bpm) than during C (137.1 (5.7) bpm) and R (136.2 (10.5) bpm). During C and R, HR was below both VT (11% and 27-28%). HR differences between S and C correlated with C, R and final times. The greatest differences between S and C were related to the worst times in the next stages. These ultra-endurance triathletes performed S at a higher relative intensity, which was inversely correlated with performance in the following stages. The best predictors of final racing time (81%) were weight-adjusted ˙VO2max and HR difference between C and S. A more adequate characterization of the time pattern during the whole race, especially during S, adds new information concerning the intensity profile and cardiovascular demands of an UET race.

Perceived exertion, time of immersion and physiological correlates in synchronized swimming.

This study examined the relationship between ratings of perceived exertion (RPE, CR-10), heart rate (HR), peak blood lactate (La peak), and immersion (IM) parameters in 17 elite synchronized swimmers performing 30 solo and duet routines during competition. All were video recorded (50 Hz) and an observational instrument was used to time the IM phases. Differences in the measured variables were tested using a linear mixed-effects model. RPE was 7.7 ± 1.1 and did not differ among routines, and neither did any of the HR parameters. There were differences among routines in La peak (F3,7=16.5; P=0.002), number of IM (F3,15=14.0; P<0.001), total time immersed (F3,16=26.6; P<0.001), percentage of time immersed (F3,13=6.5; P=0.007) and number of IM longer than 10 s (F3,19=3.0; P=0.04). RPE correlated positively to HR pre-activation, range of variation and recovery, IM parameters and La peak, and inversely to minimum and mean HR. A hierarchical multiple linear regression (MLR) model (number of IM >10 s, HR recovery, minimum HR, and La peak) explained 62% RPE variance (adj. Rm 2=0.62; P<0.001). A stepwise MLR model (La peak, mean IM time and pre-exercise HR) explained 46% of performance variance (adj. Rm 2=0.46; P<0.001). Findings highlight the psycho-physical stress imposed by the combination of intense dynamic exercise with repeated and prolonged apnea intervals during SS events.

Isometric knee extensor fatigue following a Wingate test: peripheral and central mechanisms.

Central and peripheral fatigue have been explored during and after running or cycling exercises. However, the fatigue mechanisms associated with a short maximal cycling exercise (30 s Wingate test) have not been investigated. In this study, 10 volunteer subjects performed several isometric voluntary contractions using the leg muscle extensors before and after two bouts of cycling at 25% of maximal power output and two bouts of Wingate tests. Transcranial magnetic stimulation (TMS) and electrical motor nerve stimulation (NM) were applied at rest and during the voluntary contractions. Maximal voluntary contraction (MVC), voluntary activation (VA), twitch amplitude evoked by electrical nerve stimulation, M wave and motor potential evoked by TMS (MEP) were recorded. MVC, VA and twitch amplitude evoked at rest by NM decreased significantly after the first and second Wingate tests, indicating central and peripheral fatigue. MVC and VA, but not the twitch amplitude evoked by NM, recovered before the second Wingate test. These results suggest that the Wingate test results in a decrease in MVC associated with peripheral and central fatigue. While the peripheral fatigue is associated with an intramuscular impairment, the central fatigue seems to be the main reason for the Wingate test-induced impairment of MVC.

New indices for quantification of the power spectrum of heart rate variability time series without the need of any frequency band definition.

This paper presents a new family of indices for the frequency domain analysis of heart rate variability time series that do not need any frequency band definition. After proper detrending of the time series, a cumulated power spectrum is obtained and frequencies that contain a certain percentage of the power below them are identified, so median frequency, bandwidth and a measure of the power spectrum asymmetry are proposed to complement or improve the classical spectral indices as the ratio of the powers of LF and HF bands (LF/HF). In normal conditions the median frequency provides similar information as the classical indices, while the bandwidth and asymmetry can be complementary measures of the physiological state of the tested subject. The proposed indices seem to be a good choice for tracking changes in the power spectrum in exercise stress, and they can guide in the determination of frequency band limits in other animal species.

Pubic bone anchoring devices for the surgical treatment of urinary stress incontinence in patients with severe genital prolapse.

The aim of this study was to test a surgical technique for the treatment of stress urinary incontinence associated with genital prolapse through a transvaginal suspension anchored to the pubic bone. Thirty-seven patients with severe genital prolapse and urodynamically proven stress incontinence were operated on with this procedure from February 1998 to May 2000. Preoperatively a detailed history, pelvic examination and urodynamic studies were carried out. The degree of prolapse was assessed pre- and postoperatively in the lithotomy position in accordance with the classification proposed by Baden and Walker [8]. Two titanium bone screws with no. 1 polypropylene sutures attached to them and a battery-operated screw inserter are used to fix the vaginal sutures to the pubic bone bilaterally. The procedure is performed transvaginally with no abdominal or suprapubic incisions. Objective outcomes were assessed by symptom assessment, clinical examination and a full urodynamic evaluation at 6 months postoperatively, and annually by clinical evaluation. Subjective outcomes were assessed by directly interviewing the patients about their postoperative urinary symptoms and asking them to classify their level of satisfaction. An objective cure rate (no objective loss of urine during coughing in the absence of a simultaneous detrusor contraction) at the 6-month postoperative urodynamic evaluation was observed in 23 of 37 patients (62%). Recurrent anterior vaginal wall prolapse (grade 2) had developed in 7 of 37 patients (27%). Subjectively, 73% of the patients expressed satisfaction with the procedure. Early results using two bone screws into the pubis to fix the periurethral and perivesical tissues and vagina to the posterior surface of the pubic bone were disappointing. Based on our results we have abandoned the use of this procedure to correct stress incontinence associated with severe genital prolapse.

Ganglio centinela en el carcinoma de mama. Estudio de 175 casos / Sentinel node in breast carcinoma. Study of 175 cases

Objetivo: Evaluar la eficacia del estudio selectivo del ganglio centinela en el carcinoma de mama. Sujetos: Se incluye en este trabajo a 175 pacientes repartidas en dos grupos. El primero de 105 formado por neoplasias en estadios T1 y T2 y que sirvió para realizar la necesaria curva de aprendizaje en el que realizamos estudio de ganglio centinela y linfadenectomía reglada. Una vez validada la técnica, el grupo de aplicación terapéutica fue formado por 70 pacientes en estadios T1 y T2 de tamaño inferior a 2,5 cm. Resultados: En el grupo de aplicación clínica hemos detectado el ganglio centinela correctamente en el 98,5 per cent de los casos (eficacia), tanto por linfogammagrafía como intraoperatoriamente. Nuestra cifra de falsos negativos es del 0 per cent con un seguimiento clínico de estas pacientes de 8 meses. La sensibilidad del procedimiento y el valor predictivo negativo son del 100 per cent. Conclusiones: El estudio del ganglio centinela en el carcinoma de la mama nos ha permitido disminuir la morbilidad de la cirugía, reducir los ingresos hospitalarios y mejorar la recuperación de las pacientes. (AU)

Mycosis fungoides and pregnancy.

Mycosis fungoides is a cutaneous T-cell lymphoma, a subgroup of non-Hodgkin's lymphomas, characterized by skin infiltration and occasionally systemic involvement. The association of pregnancy and mycosis fungoides has not been described previously. A case of mycosis fungoides, stage IVb, in a pregnant woman is reported. Prior to pregnancy, the patient received adriamycin, cyclophosphamide, vincristine prednisolone (CHOP) and bleomycin and total body irradiation. Around the concepcional period she presented a cutaneous relapse palliated with photon radiotherapy. No obstetrics complications were observed during gestation. At 39 week's gestation a cesarean section was performed and a healthy 2900 g boy was delivered. Mycosis fungoides did not worsen during pregnancy and postpartum period. In conclusion mycosis fungoides did not adversely affect pregnancy outcome and gestation did not worsen the malignancy course. This case report may be valuable in managing patients with mycosis fungoides who are currently pregnant or are contemplating pregnancy.

Intraabdominal desmoplastic small round cell tumor with EWS/ERG fusion transcript.

This report describes an intraabdominal small cell tumor in a 37-year-old woman, with clinical, topographic, and morphologic features highly suggestive of the desmoplastic small round cell tumor. Immunohistochemical analysis revealed a polyphenotypic profile consistent with this tumor--positivity for keratin, epithelial membrane antigen, neuron-specific enolase, vimentin, and desmin--but, in addition, a strong membranous immunoreactivity for CD99 (MIC2 protein). Reverse transcription polymerase chain reaction revealed a EWS/ERG fusion transcript characteristic of the Ewing's sarcoma/peripheral primitive neuroectodermal tumor group of tumors, rather than the EWS/WT1 chimeric transcript typical of the desmoplastic small round cell tumor. This is the third report of a hybrid tumor with features of the desmoplastic small round cell tumor and Ewing's sarcoma/peripheral primitive neuroectodermal tumor, and the first one with the EWS/ERG fusion gene. Our case shows the existence of some overlap between these two groups of tumors, which are considered to be histogenetically different, and the need for further studies of molecular characterization of small cell tumors, especially in those with atypical morphologic or immunohistochemical features.

[The detection of papillomavirus by in situ hybridization. Clinico-pathological and virological correlation in patients with squamous intraepithelial lesions of the uterine cervix]. / Determinación del papiloma virus mediante hibridación in situ. Correlación clinicopatológica y virológica en pacientes con lesiones escamosas intraepiteliales del cérvix uterino.

BACKGROUND: Clinical usefulness of human papillomavirus (HPV) detection by molecular techniques is not well established. The aim of the study is to determine, by in situ hybridization, HPV DNA in patients with cervical intraepithelial neoplasia (CIN), assessing the prevalence rate, the association with epidemiologic factors and the correlation with classic diagnostic procedures (cytology, colposcopy and histology). PATIENTS AND METHODS: Among 138 patients diagnosed with CIN, HPV was determined in 75 treated by excisional procedures. All cases underwent pap-smear, colposcopy, and colposcopically directed biopsy. RESULTS: Histologic diagnosis was as follows: 1 cervical condyloma (1.3%); 31 CIN-I (41.3%); 23 CIN II (30.7%), and 20 CIN-III (26.7%). HPV was detected in 31 cases (41.3%), being more frequent in higher histologic grades (35.5%) CIN-I, 43.5% CIN-II and 45% CIN-III). No association between cytologic, colposcopic and histologic diagnoses and HPV positivity was observed. HPV detection in patients with false negative cytologies was lower than in positive ones (p = 0.021). Smoking was the only epidemiologic factor significantly associated to HPV presence (chi 2 for trend = 4.022; p = 0.045). CONCLUSIONS: Clinical usefulness of in situ hybridization for HPV detection remains controversial because of its low sensitivity, and the scarce relationship between its results and those obtained by cytology, colposcopy and histology. Smoking is associated with a higher detection rate of HPV in patients with squamous intraepithelial lesions of the uterine cervix.

Maternal brain death during pregnancy.

A case of a 36-year-old woman diagnosed brain dead secondary to pneumococcal meningitis at 27 weeks of gestation is presented. In spite of aggressive therapy, supportive intensive care was possible for only 36 h. Signs of fetal distress appeared and a cesarean section was performed. The complexity of supportive care and its ethical implications are discussed.

Successful pregnancy after spontaneous remission of familial pulmonary alveolar proteinosis.

In this report we describe a case of a successful pregnancy in a 19-year-old patient suffering from the familial form of pulmonary alveolar proteinosis, a very rare pulmonary disorder. The pregnancy course was complicated by preterm labour. The outcome and management are discussed.

Massive metastases from a lobular breast carcinoma from an unknown primary during pregnancy. A case report.

BACKGROUND: Carcinoma of the breast during pregnancy represents 2-5% of all breast cancers. The frequency and histopathologic spectrum of breast cancer are similar in pregnant and nonpregnant women. Infiltrating lobular carcinoma is one of the less understood types of breast cancer, and its metastatic pattern seems to be different from that of infiltrating ductal carcinoma. Breast neoplasms rarely present as cancer from an unknown primary site. CASE: A woman in the third trimester of pregnancy developed carcinoma massively metastatic to the bone marrow and liver from an unknown primary tumor. At 32 weeks' gestation a healthy male was delivered by cesarean section. The patient died 12 hours after delivery. The autopsy revealed an infiltrating lobular carcinoma, 1.5 cm, of the breast. CONCLUSION: Massive metastases from an occult lobular breast carcinoma in a pregnant woman are very rare. Diffuse metastatic spread, which often complicates or delays the diagnosis, is a characteristic pattern of infiltrating lobular carcinoma. Cancer from an unknown primary site during pregnancy is an exceptional finding. If a metastatic adenocarcinoma is diagnosed in a pregnant woman, a breast primary should be strongly suspected.

Circulating hormone levels in menopausal women receiving different hormone replacement therapy regimens. A comparison.

OBJECTIVE: To measure and compare plasma levels of sex hormones after the administration of different hormone replacement therapy (HRT) regimens. STUDY DESIGN: Ninety women with natural menopause were randomized into this comparative study. Eighty-five women completed one year of follow-up. Patients were randomly assigned to five groups. The first received 0.6 mg/d of conjugated equine estrogen (CEE) cyclically (n = 15). The second received 50 micrograms/d of transdermal estradiol (E2) cyclically (n = 17), and the third received 0.6 mg/d of CEE continuously (n = 17). All these groups also received 2.5 mg of medroxyprogesterone acetate (MPA) sequentially for the last 12 days of HRT, while the fourth therapy group received 0.625 mg/d of CEE and 2.5 mg/d of MPA continuously (n = 19). The fifth group constituted a treatment-free control group (n = 22). Levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), E2, estrone (E1), prolactin (PRL), testosterone (T), androstenedione (A4), dehydroepiandrosterone sulfate (DHEA-S) and sex hormone binding globulin (SHBG) were determined prior to HRT and during the last week of the 6th and 12th months of HRT, between days 21 and 24 of estrogen administration. RESULTS: After HRT we found decreases in FSH, LH and PRL levels, increases in E2, E1 and SHBG, and no modifications in T, A4 and DHEA-S plasma levels. There were no significant differences between the treatment groups in FSH, LH, E2, PRL, T, A4 or DHEA-S. E1 and SHBG were significantly higher in the groups with oral HRT. CONCLUSION: All the observed changes in hormone levels are to be expected after HRT except for the decrease in PRL levels. Finally, although MPA dosage was not the focus of the present study, our results suggest that the dosage of 2.5 mg/d of MPA in sequential regimens is clearly inadequate to protect the endometrium from hyperplastic changes.

Is MRI helpful in evaluating the response of cervical cancer to neoadjuvant chemotherapy?

BACKGROUND: To assess the potential role of magnetic resonance imaging (MRI) in evaluating the response of cervical tumor to neoadjuvant chemotherapy. METHODS: We studied 14 patients with locally advanced carcinoma of the cervix. MRI was performed before and after each cycle. All patients underwent laparotomy four weeks after the last cycle. MR images after chemotherapy were compared with surgical-pathologic findings. RESULTS: Related to parametrial state after chemotherapy, surgical examination correlated with MRI in nine patients (nine true negative). In three cases parametrial invasion was over-estimated (three false-positive) and in two it was underestimated, so that tumor resection was not possible once laparotomy was performed (two false-negative). MRI estimation of tumor size was confirmed at pathologic examination in only eight patients, whilst it was over-estimated in the other four ones. CONCLUSIONS: These initial results suggest that MRI could not be as precise for cervix cancer staging and evaluation of response to chemotherapy as has recently been postulated. This is especially important since a false negative result may induce the surgeon to perform laparotomy in error in cases of unresectable tumors.

Immediate maternal and neonatal effects of low-forceps delivery according to the new criteria of The American College of Obstetricians and Gynecologists compared with spontaneous vaginal delivery in term pregnancies.

OBJECTIVE: Our purpose was to investigate the maternal and neonatal effects of elective low-forceps delivery, as currently defined by the 1988 criteria of The American College of Obstetricians and Gynecologists. STUDY DESIGN: During a 6-month period we conducted a prospective study that included 50 nulliparous term parturients who were randomly allocated to spontaneous or elective low-forceps delivery. Patients with either maternal or fetal disorders that could affect the outcome were excluded. All deliveries were attended by three experienced obstetricians. RESULTS: Spontaneous and forceps delivery group were similar regarding maternal or gestational age, fetal scalp pH, antepartum maternal hemoglobin and hematocrit levels, maternal outcome, mean birth weight, and number of neonates with low Apgar scores or cord arterial pH < 7.20. In the spontaneous delivery group the time elapsed since randomization to delivery was significantly longer (18 vs 10.2 minutes, p < 0.001) and the mean cord arterial pH was significantly lower (7.23 vs 7.27, p = 0.01) than in the forceps delivery group. CONCLUSION: Elective low forceps delivery may be used to shorten the second stage of labor without immediate maternal or neonatal side effects.

Solitary vaginal metastasis as a presenting form of unsuspected renal adenocarcinoma.

Vaginal bleeding may be the first clinical manifestation of an occult renal neoplasm. The renal adenocarcinoma is a tumor with a wide variety of presenting forms. Sometimes the clinical signs of the metastatic lesions are the first evidence of disease. The prevalence of solitary metastases at diagnosis is lower than 3%, and solitary vaginal metastasis from this tumor is rare. Histologically, this metastasis is indistinguishable from that of a primary vaginal mesonephric adenocarcinoma, making electron microscopy necessary for the differential diagnosis. Treatment consists of surgical removal of the renal neoplasm as well as the vaginal lesion.