Re-admissions for delayed complications after cytoreductive surgery and HIPEC.

BACKGROUND: Peritoneal metastasis (PM) is currently treated with the complex procedure of cytoreductive surgery and hyperthermic intra-peritoneal chemotherapy (CRS + HIPEC). This procedure presents high morbidity and mortality rates, but they have only been examined in the immediate post-operative period. The aim of our study is to present, describe and analyze the post-operative events, secondary to a cytoreductive surgery and HIPEC procedure that occurs after the patients' discharge from the hospital. PATIENTS AND METHODS: We examine retrospectively 219 patients who were discharged from our hospital from the initial 230 patients with PM, who were operated on from August 2005 to August 2015 and underwent CRS and HIPEC. Complications are investigated from the patient's discharge date until the 90th post-operative day, and are categorized with the Clavien-Dindo classification. RESULTS: We identified 17 patients (7.8%) who developed late complications. No major differences in patient characteristics were identified between this group of 17 patients and the rest, apart from a slightly higher PCI (23.5 vs. 22.3). Mean length of stay at the re-admission was 11.7 days. 5 of the patients (29.4%) had to be re-operated on, whereas we found a mortality of 11.8% (2/17 patients). The most common complications involved abdominal abscesses (17.6%), ureteral strictures (17.6%) and enterocutaneous fistulae (17.6%). CONCLUSION: Our study highlights the late complications following CRS plus HIPEC procedures, that occur after the patient's discharge from the hospital, an issue that has not been investigated thoroughly yet and may have serious impact on the post-operative quality of life. The role of adjuvant chemotherapy following CRS and HIPEC procedures in the onset of such complications appears to be important and needs further investigation.

The effects of resisted sled-pulling sprint training on acceleration and maximum speed performance.

AIM: The purpose of the present study was to examine the effects of resisted (RS) and un-resisted (US) sprint training programs on acceleration and maximum speed performance. METHODS: Twenty-two male students (age 20.1+/-1.9 y, height 1.78+/-7 cm, and weight 73+/-2 kg) completed RS (n=11) or US (n=11) sprint training programs. The RS group followed a sprint-training program with 5 kg sled pulling and the US group followed a similar sprint-training program without sled pulling. The training program consisted of 4x20 m and 4x50 m maximal runs, and was applied 3 times/week for 8 weeks. Before and after the training programs the subjects performed a 50 m run and the running velocity of 0(-1)0 m, 10(-2)0 m, 20-40 m and 40-50 m was measured. In addition, stride length and stride frequency were evaluated at the 3(rd) stride in acceleration phase and between 42-47 m in maximum speed phase. RESULTS: The RS improved running velocity in the run sections 0(-1)0 m and 0(-2)0 m, while in US group the running velocity in all run sections in acceleration phase remained unchanged (p>0.05). In contrast, RS training had no effect on running velocity in maximum speed phase, whereas US improved running velocity in 20-40 m, 40-50 m, and 20-50 m run sections (p<0.05). Stride rate increased only after RS in acceleration phase (+7.1+/-2.9%; p<0.05), whereas stride length increased only after US in maximum speed phase (+5.5+/-2.5%; p<0.05). CONCLUSION: Sprint training with 5 kg sled pulling for 8 weeks improves acceleration performance (0(-2)0), while un-resisted sprint training improves performance in maximum speed phase (20-40) in non-elite athletes. It appears that each phase of sprint run demands a specific training approach.

Prediction of knee extensor and flexor isokinetic strength in young male soccer players.

STUDY DESIGN: Single group, cross-sectional study. OBJECTIVES: To measure various anthropometric and demographic variables in young male soccer players and to use these measurements to develop equations with which to predict the isokinetic, concentric, and eccentric moment of force. BACKGROUND: The development of equations that can predict isokinetic muscle strength from commonly measured subject characteristics can assist in the effective design of training and rehabilitation programs for athletic children. METHODS AND MEASURES: One hundred thirteen male soccer players (13.50 +/- 2.21 years of age) performed eccentric and concentric maximum efforts of the knee extensors and flexors at 60, 120, and 180 degrees/second. Stepwise regression tests were used to develop predictive equations using combinations of age, height, body mass, sexual maturation (Tanner) stage, percentage of body fat, and hours spent training per week. RESULTS: The results indicated a significant relationship of concentric and eccentric isokinetic strength for both knee extensors and flexors with 73-93% of the variance explained by using combinations of age, body mass, percentage of body fat, and hours training per week. Body mass and age were the main predictor variables under concentric conditions, whereas chronological age was not included in the models under eccentric conditions. CONCLUSIONS: The relation between isokinetic moment and multiple anthropometric and demographic variables depends on the type of muscle action examined. The results suggest that the equations we developed can be used to predict the isokinetic moment in trained, young soccer players. A cross-validation analysis is required to confirm the accuracy and the suitability of the equations developed in our study.